{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T13:55:12Z","timestamp":1736776512575,"version":"3.33.0"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJHP"],"abstract":"<jats:p>Background: Extravasation is the erroneous delivery of IV medication or fluid into the extravascular space. Complications ranging from mild injury to amputation can result, depending on the physical and pharmacologic properties of the infusate. Children are at increased risk for extravasation injuries. There is a paucity of data on the treatment and outcomes of extravasation injuries, particularly in terms of the role of pharmacologic antidotes.\nObjectives: To describe the incidence of extravasation at a tertiary pediatric care centre (as an update to a previous study), to identify the agents most commonly involved in extravasation injuries, to describe the antidotes used for management of injuries and their related adverse drug effects, and to describe complications related to injuries.\nMethods: The medical records of pediatric patients who experienced an extravasation injury at the BC Children\u2019s and BC Women\u2019s Hospitals, between September 1, 2008, and September 30, 2020, were reviewed. Data regarding management (adherence with institutional protocol) and outcomes of injuries were collected.\nResults: The 242 charts included in the analysis noted a total of 245 extravasation injuries, for an extravasation incidence of 0.04% per patient-day. Of the 242 patients, 110 were excluded from secondary outcome analysis due to lack of data detailing the extravasation event. Of the remaining 132 patients, the majority were neonates (n = 54, 40.9%), infants (n = 33, 25.0%), and children (n = 34, 25.8%), and more than a third were treated on general pediatric wards (n = 50, 37.9%). The medications most frequently involved were total parenteral nutrition with lipids (36\/132, 27.3%), vancomycin (36\/132, 27.3%), and IV fluids (35\/132, 26.5%). Most of the patients had mild outcomes and recovered without complications. No adverse drug events from antidotes were reported.\nConclusions: The incidence of extravasation at the study institution remained low, with the medications involved being similar to those reported in the literature and the majority of patients having mild outcomes. Additional prospective studies are needed to assess the efficacy and safety of antidotes administered for extravasation injuries.\nKeywords: extravasation, IV medications, pediatrics, hyaluronidase, phentolamine, infiltration\nR\u00c9SUM\u00c9\nContexte : L\u2019extravasation est l\u2019administration erron\u00e9e de m\u00e9dicaments ou de liquides IV dans l\u2019espace extravasculaire. Des complications allant d\u2019une blessure l\u00e9g\u00e8re \u00e0 l\u2019amputation peuvent en r\u00e9sulter, en fonction des propri\u00e9t\u00e9s physiques et pharmacologiques de la perfusion. Les enfants courent un risque accru de blessures par extravasation. Il existe peu de donn\u00e9es sur le traitement et les cons\u00e9quences des blessures par extravasation, notamment en ce qui concerne le r\u00f4le des antidotes pharmacologiques.\nObjectifs : D\u00e9crire l\u2019incidence des extravasations dans un centre de soins p\u00e9diatriques tertiaires (en tant que mise \u00e0 jour d\u2019une \u00e9tude pr\u00e9c\u00e9dente), recenser les agents les plus couramment impliqu\u00e9s dans les blessures par extravasation, d\u00e9crire les antidotes utilis\u00e9s pour la gestion des blessures et leurs effets ind\u00e9sirables li\u00e9s aux m\u00e9dicaments et d\u00e9crire les complications li\u00e9es aux blessures.\nM\u00e9thodologie : Les dossiers m\u00e9dicaux des patients p\u00e9diatriques ayant subi une blessure par extravasation entre le 1er septembre 2008 et le 30 septembre 2020 aux h\u00f4pitaux BC Children's Hospital et BC Women\u2019s Hospital ont \u00e9t\u00e9 examin\u00e9s. Des donn\u00e9es concernant la prise en charge (c\u2019est-\u00e0-dire le respect du protocole de l\u2019\u00e9tablissement) et les cons\u00e9quences des blessures ont \u00e9t\u00e9 recueillies.\nR\u00e9sultats : Les 242 dossiers inclus dans l\u2019analyse indiquaient un total de 245 blessures par extravasation, pour une incidence d\u2019extravasation de 0,04 % par jour-patient. Parmi les 242 patients, 110 ont \u00e9t\u00e9 exclus del\u2019analyse secondaire des cons\u00e9quences en raison d\u2019un manque de donn\u00e9es concernant les d\u00e9tails de l\u2019extravasation. Sur les 132 patients restants, la majorit\u00e9 \u00e9tait des nouveau-n\u00e9s (n = 54, 40,9 %), des nourrissons (n = 33, 25,0 %) et des enfants (n = 34, 25,8 %) et plus du tiers ont re\u00e7u des soins dans un service de p\u00e9diatrie g\u00e9n\u00e9rale (n = 50, 37,9 %). Les m\u00e9dicaments les plus fr\u00e9quemment impliqu\u00e9s \u00e9taient la nutrition parent\u00e9rale totale avec des lipides (36\/132, 27,3 %), la vancomycine (36\/132, 27,3 %) et des liquides IV (35\/132, 26,5 %). Les cons\u00e9quences sur la plupart des patients \u00e9taient b\u00e9nignes et ils se sont r\u00e9tablis sans complications. Aucun effet ind\u00e9sirable li\u00e9 aux antidotes n\u2019a \u00e9t\u00e9 signal\u00e9.\nConclusions : L\u2019incidence des extravasations dans l\u2019\u00e9tablissement \u00e0 l\u2019\u00e9tude est rest\u00e9e faible, les m\u00e9dicaments impliqu\u00e9s \u00e9tant similaires \u00e0 ceux rapport\u00e9s dans la litt\u00e9rature et les cons\u00e9quences pour la majorit\u00e9 des patients \u00e9taient b\u00e9nignes. Des \u00e9tudes prospectives suppl\u00e9mentaires sont n\u00e9cessaires pour \u00e9valuer l\u2019efficacit\u00e9 et la s\u00e9curit\u00e9 des antidotes administr\u00e9s pour les blessures par extravasation.\nMots-cl\u00e9s : extravasation, m\u00e9dicaments IV, p\u00e9diatrie, hyaluronidase, phentolamine, infiltration<\/jats:p>","DOI":"10.4212\/cjhp.3525","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T16:27:55Z","timestamp":1718209675000},"source":"Crossref","is-referenced-by-count":0,"title":["Describing Intravenous Extravasation Injuries in Children (DIVE2 Study)"],"prefix":"10.4212","volume":"77","author":[{"given":"Jamil","family":"Devsi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanessa","family":"Paquette","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxane","family":"Carr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2024,6,12]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3525\/5338","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3525\/5339","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3525\/5338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T16:27:55Z","timestamp":1718209675000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,12]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,4,10]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3525","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"type":"electronic","value":"1920-2903"},{"type":"print","value":"0008-4123"}],"subject":[],"published":{"date-parts":[[2024,6,12]]}}}