{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:15:48Z","timestamp":1777418148883,"version":"3.51.4"},"reference-count":26,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[1998,1,1]],"date-time":"1998-01-01T00:00:00Z","timestamp":883612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[1998,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To report two cases of parenteral nutrition extravasation and their treatment in adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CASE SUMMARIES:<\/jats:title>\n                    <jats:p>Case 1: A 23-year-old white woman was admitted to our hospital diagnosed with a gastrointestinal infection by Salmonella paratyphi sv. B. The treatment included peripheral parenteral nutrition (osmolarity 652 mOsm\/L). After 4 days an extravasation of parenteral nutrition was detected in the left antecubital fossa. The affected area soon became inflamed. Chondroitinsulfatase 150 turbidity-reducing units (TRUs), diluted in 3 mL of NaCl 0.9% and administered in six subcutaneous applications around the area, was prescribed. The treatment was successful. The patient was discharged several days later with no sequelae of the extravasation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case 2<\/jats:title>\n                    <jats:p>A 33-year-old white woman was admitted to the intensive care unit after surgery for a necrohemorrhagic pancreatitis. The treatment included parenteral nutrition via a central catheter (osmolarity 2130 mOsm\/L). Two days later the patient presented a parenteral nutrition subcutaneous extravasation in her left hemithorax around the catheter access site. Chondroitinsulfatase 200 TRUs, diluted in 2 mL of NaCl 0.9% and administered in eight subcutaneous applications around the area, was prescribed. No sequelae of the incident remained. The patient was discharged home 2 months later.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Parenteral nutrition solution can cause tissue harm after extravasation. Both patients presented an intense inflammatory reaction after the accident. Three treatments have been used in extravasation of parenteral nutrition, but in our patients hyaluronidase was the only applicable treatment. As this enzyme is not commercially available in Spain, chondroitinsulfatase, an enzyme very similar to hyaluronidase, was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Chondroitinsulfatase was useful in treating extravasation of parenteral nutrition in two adult patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJETIVO<\/jats:title>\n                    <jats:p>Describir dos casos de extravasaci\u00f3n de nutrici\u00f3n parenteral en pacientes adultos y el tratamiento aplicado.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESUMEN DEL CASOS<\/jats:title>\n                    <jats:p>Caso 1: Una mujer de 23 a\u00f1os ingres\u00f3 con el diagn\u00f3stico de infecci\u00f3n gastrointestinal por Salmonella paratyphy B. Su tratamiento incluy\u00f3 nutrici\u00f3n parenteral perif\u00e9rica (osmolaridad 652 mOsm\/L). Cuatro d\u00edas despu\u00e9s de su inicio se detect\u00f3 una extravasaci\u00f3n de nutrici\u00f3n parenteral en la fosa antecubital. La zona afectada pronto apareci\u00f3 inflamada. Se prescribieron 150 unidades reductoras de turbidez (URT) diluidas en 3 mL de NaCl 0.9% distribuidas en seis aplicaciones subcut\u00e1neas alrededor de la zona. El tratamiento tubo \u00e9xito. La paciente fue dada de alta algunos d\u00edas despu\u00e9s sin ninguna secuela de la extravasaci\u00f3n. Caso 2: Una mujer de 33 a\u00f1os ingres\u00f3 en la unidad de cuidados intensivos despu\u00e9s de una intervenci\u00f3n quir\u00fargica por una pancreatitis necrohemorr\u00e1gica. El tratamiento incluy\u00f3 nutrici\u00f3n parenteral a trav\u00e9s de un cat\u00e9ter central (osmolaridad 2130 mOsm\/L). Dos d\u00edas despu\u00e9s la paciente present\u00f3 una extravasaci\u00f3n subcut\u00e1nea de nutrici\u00f3n parenteral en su hemit\u00f3rax izquierdo alrededor del punto de inserci\u00f3n del cat\u00e9ter. Se prescribi\u00f3 condroitinsulfatasa 200 URT diluidas en 2 mL de NaCl 0.9% distribuidas en ocho aplicaciones subcut\u00e1neas alrededor de la zona. No quedaron secuelas del accidente. La paciente fue dada de alta 2 meses despu\u00e9s.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSION<\/jats:title>\n                    <jats:p>La nutrici\u00f3n parenteral puede causar da\u00f1o tisular si se extravasa. Nuestras dos pacientes presentaron una intensa reacci\u00f3n inflamatoria despu\u00e9s del accidente. En las extravasaciones de nutrici\u00f3n parenteral se han aplicado tres tratamientos, pero en nuestros casos el \u00fanico aplicable era la hialuronidasa. A la vista de que este enzima no est\u00e1 comercializado en nuestro pa\u00eds se utiliz\u00f3 la condroitinsulfatasa, que es muy similar a la hialuronidasa.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONES<\/jats:title>\n                    <jats:p>La condroitinsulfatasa fue \u00fatil en el tratamiento de la extravasaci\u00f3n de nutrici\u00f3n parenteral en dos pacientes adultos.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIF<\/jats:title>\n                    <jats:p>Rapporter deux cas d'extravasation de solutions d'alimentation parent\u00e9rale survenus chez des adultes ainsi que le traitement institu\u00e9.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00c9SUM\u00c9 DU CAS<\/jats:title>\n                    <jats:p>Cas 1: Une femme \u00e2g\u00e9e de 23 ans a \u00e9t\u00e9 admise \u00e0 l'h\u00f4pital avec un diagnostic d'infection gastrointestinale \u00e0 Salmonella paratyphy B. En cours d'hospitalisation, une alimentation parent\u00e9rale par voie p\u00e9riph\u00e9rique (osmolarit\u00e9 652 mOsm\/L) a \u00e9t\u00e9 prescrite. Quatre jours plus tard, une extravasation de la solution d'alimentation parent\u00e9rale \u00e9tait d\u00e9tect\u00e9e au niveau de la fosse ant\u00e9cubitale gauche. De l'inflammation s'est rapidement manifestee au niveau de la zone affect\u00e9e. De la chondro\u00eftine sulfatase 150 \u201cturbidity-reducing units\u201d (TRU) dilu\u00e9e dans 3 mL de NaCl 0.9% a \u00e9t\u00e9 prescrite et administr\u00e9e en six injections sous-cutan\u00e9es au pourtour de la zone affect\u00e9e. Le traitement s'est av\u00e9r\u00e9 efficace et la patiente a pu quitter l'h\u00f4pital quelques jours plus tard sans aucune s\u00e9quelle de l'extravasation. Cas 2: Une femme \u00e2g\u00e9e de 33 ans a \u00e9t\u00e9 admise \u00e0 l'unit\u00e9 des soins intensifs apr\u00e8s une chirurgie pour une pancr\u00e9atite n\u00e9croh\u00e9morragique. Une alimentation parent\u00e9rale par voie centrale (osmolarit\u00e9 2130 mOsm\/L) a \u00e9t\u00e9 prescrite. Deux jours plus tard, une extravasation sous-cutan\u00e9e de la solution d'alimentation parent\u00e9rale \u00e9tait not\u00e9e au niveau de l'h\u00e9mithorax gauche, au pourtour du site d'insertion du cath\u00e9ter central. De la chondro\u00eftine sulfatase 200 TRU dilu\u00e9e dans 2 mL de NaCl 0.9% a \u00e9t\u00e9 administr\u00e9e en huit injections sous-cutan\u00e9es au pourtour de la zone affect\u00e9e. Aucune s\u00e9quelle de l'extravasation n'a \u00e9t\u00e9 observ\u00e9e. La patiente a quitt\u00e9 l'h\u00f4pital 2 mois plus tard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>L'extravasation d'une solution d'alimentation parent\u00e9rale peut causer des dommages tissulaires. Les cas rapport\u00e9s ici ont pr\u00e9sent\u00e9 une r\u00e9action inflammatoire importante \u00e0 la suite de l'extravasation. Jusqu'\u00e0 pr\u00e9sent, trois modalit\u00e9s de traitement ont \u00e9t\u00e9 utilis\u00e9es lors de l'extravasation de solutions d'alimentation parent\u00e9rale mais dans les deux cas rapport\u00e9s plus haut, seule la hyaluronidase constituait un choix acceptable. Comme cette enzyme n'est pas disponible sur le march\u00e9 espagnol, la chondro\u00eftine sulfatase, une enzyme tr\u00e8s semblable \u00e0 la hyaluronidase, a \u00e9t\u00e9 utilis\u00e9e.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>La chondro\u00eftine sulfatase s'est av\u00e9r\u00e9e utile pour traiter l'extravasation de solutions d'alimentation parent\u00e9rale chez deux adultes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.16487","type":"journal-article","created":{"date-parts":[[2004,3,11]],"date-time":"2004-03-11T17:08:19Z","timestamp":1079024899000},"page":"51-55","source":"Crossref","is-referenced-by-count":22,"title":["Treatment of Extravasation from Parenteral Nutrition Solution"],"prefix":"10.1177","volume":"32","author":[{"given":"Mar\u00eda-Esperanza","family":"Gil","sequence":"first","affiliation":[{"name":"Mar\u00eda-Esperanza Gil PharmD, Resident in Hospital Pharmacy, Departament de Far-m\u00e0cia, Hospital Universitari Joan XXIII, Tarragona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Mateu","sequence":"additional","affiliation":[{"name":"Javier Mateu PharmD, Hospital Pharmacist, Departament de Farm\u00e0cia, Hospital Universitari Joan XXIII"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1998,1,1]]},"reference":[{"key":"bibr-bibr1-aph.16487","first-page":"283","volume-title":"Nutrition support handbook","author":"Lehmann S","year":"1992"},{"key":"bibr-bibr2-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/0148607189013006628"},{"key":"bibr-bibr3-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/106002808301701002"},{"key":"bibr-bibr4-aph.16487","volume-title":"Drugdex system","author":"Tatro DS","year":"1996"},{"key":"bibr-bibr5-aph.16487","doi-asserted-by":"publisher","DOI":"10.1136\/fn.70.1.F50"},{"key":"bibr-bibr6-aph.16487","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-197511000-00003"},{"key":"bibr-bibr7-aph.16487","doi-asserted-by":"publisher","DOI":"10.1016\/0007-1226(93)90137-Z"},{"key":"bibr-bibr8-aph.16487","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(79)90121-1"},{"key":"bibr-bibr9-aph.16487","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)92682-7"},{"key":"bibr-bibr10-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/000992288502400109"},{"key":"bibr-bibr11-aph.16487","doi-asserted-by":"publisher","DOI":"10.1136\/adc.67.10_Spec_No.1201"},{"key":"bibr-bibr12-aph.16487","doi-asserted-by":"publisher","DOI":"10.1136\/fn.72.3.F207"},{"key":"bibr-bibr13-aph.16487","doi-asserted-by":"publisher","DOI":"10.1007\/BF01691437"},{"key":"bibr-bibr14-aph.16487","first-page":"150","volume":"70","author":"Fletcher JP","year":"1988","journal-title":"Ann R Coll Surg Engl"},{"key":"bibr-bibr15-aph.16487","doi-asserted-by":"publisher","DOI":"10.1097\/00004728-198701000-00033"},{"key":"bibr-bibr16-aph.16487","doi-asserted-by":"publisher","DOI":"10.1016\/0268-960X(90)90015-K"},{"key":"bibr-bibr17-aph.16487","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-198409000-00003"},{"key":"bibr-bibr18-aph.16487","first-page":"77","volume":"5","author":"Zenk KE","year":"1981","journal-title":"Infusion"},{"key":"bibr-bibr19-aph.16487","unstructured":"Reynolds JEF, ed. Martindale: the extra pharmacopoeia. 31st ed. London: Royal Pharmaceutical Society of Great Britain, 1996:1759."},{"key":"bibr-bibr20-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/106002809402800732"},{"key":"bibr-bibr21-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/106002809402801106"},{"key":"bibr-bibr22-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/106002809603000306"},{"key":"bibr-bibr23-aph.16487","first-page":"157","volume":"7","author":"Jameson J","year":"1983","journal-title":"Infusion"},{"key":"bibr-bibr24-aph.16487","doi-asserted-by":"publisher","DOI":"10.1177\/0148607196020003194"},{"key":"bibr-bibr25-aph.16487","first-page":"37","volume-title":"Nutrition support handbook","author":"Teasley-Strausburg KM","year":"1992"},{"key":"bibr-bibr26-aph.16487","first-page":"353","volume-title":"Clinical nutrition. Parenteral nutrition","author":"Evans NJ","year":"1993","edition":"2"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.16487","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.16487","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:06:33Z","timestamp":1777374393000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.16487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,1]]},"references-count":26,"journal-issue":{"issue":"1","published-print":{"date-parts":[[1998,1]]}},"alternative-id":["10.1345\/aph.16487"],"URL":"https:\/\/doi.org\/10.1345\/aph.16487","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,1]]}}}