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Standard of care following extravasation of chemotherapy drugs

The recommended procedures will contribute to reducing the risk and consequences of extravasation” Vokurka et al (2019).

Abstract:

BACKGROUND: Extravasation (paravasation) of chemotherapy drugs is a very significant complication in the treatment of cancer patients. Preventive and therapeutic interventions reduce the risk of this complication or the extent of its consequences. A working group of authors from expert groups prepared recommendations for standard care.

PURPOSE: To prepare a basic summary of recommended interventions for daily practice, based on knowledge from long-term, proven, evidence-based practice or on consensus opinions of representatives of expert groups.

RESULTS: Preventive measures are essential and include early consideration of long-term venous access device indications, choice of injection site, venous line control before each chemotherapy drug application, and patient education. Interventions in cases of extravasation mainly involve the application of antidotes (dimethylsulfoxide, hyaluronidase, and dexrazoxane) and the application of dry cold or heat, depending on the type of cytostatic drug. Corticosteroids injected subcutaneously, moist heat or cooling, and compression, are not recommended.

CONCLUSION: The recommended procedures will contribute to reducing the risk and consequences of extravasation. The range of recommended interventions can be expanded depending on individual clinical workplace policy and needs. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 28. 9. 2019 Accepted: 13. 10. 2019.

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Reference:

Vokurka, S., Maňásek, V., Navrátilová Hrabánková, D., Šípová, S., Turková, L., Hajnová Fukasová, E., Sýkorová, Z., Kozáková, Š., Mazúr, R. ans Wintnerová, J. (2019) Extravasation (Paravasation) of Chemotherapy Drugs – Recommendations for Standard Care in the Czech Republic based on Consolations between Representatives of the Supportive Care Group of the Czech Society for Oncology, Oncology Section of the Czech Nurses Association, and the Society for Ports and Permanent Catheters. Klinická Onkologie. 32(6), p.463-468. doi: 10.14735/amko2019463.