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非细胞毒性药物外渗。

Extravasation of Noncytotoxic Drugs.

机构信息

Pharmacy department, CHU of Limoges, Limoges, France.

Endocrine, General and Digestive Surgery Department, CHU of Limoges, Limoges, France.

出版信息

Ann Pharmacother. 2020 Aug;54(8):804-814. doi: 10.1177/1060028020903406. Epub 2020 Feb 13.

Abstract

Commonly used drugs may be dangerous in case of extravasation. The lack of information from health care teams can lead to delays in both diagnosis and treatments. This review aims at alerting health care professionals about drugs and risk factors for extravasation and outlines recommendations for the diagnosis and treatment of extravasation. A literature search of MEDLINE/PubMed, Scopus, the Cochrane Library, and Google Scholar was performed from 2000 to December 2019 using the following terms: , and . Overall, 140 articles dealing with drug extravasation were considered potentially relevant. Each article was critically appraised independently by 2 authors, leading to the inclusion of 80 relevant studies, guidelines, and reviews. Articles discussing incidents of extravasation in the neonatal and pediatric population of patients were excluded. Training of health care teams and writing care protocols are important for an optimal management of extravasations. A prompt consultation should be achieved by a specialist surgeon. The surgical procedure, if necessary, will consist of wound debridement followed by an abundant lavage. This review discusses the management of drug extravasations according to their mechanism(s) of toxicity on tissues. It highlights the importance of a close monitoring of patients and the training of health care teams likely to face this type of adverse event. Extravasations still contribute to significant morbidity and mortality. A good knowledge of risk factors and the implementation of easily and quickly accessible standardized care protocols are 2 key elements in both prevention and treatment of extravasations.

摘要

常用药物在发生外渗时可能是危险的。医护人员信息的缺乏可能导致诊断和治疗的延误。本综述旨在提醒医护人员注意药物和外渗的危险因素,并概述外渗的诊断和治疗建议。我们对 MEDLINE/PubMed、Scopus、Cochrane 图书馆和 Google Scholar 从 2000 年到 2019 年 12 月进行了文献检索,使用了以下术语: ,和 。总体而言,考虑了 140 篇涉及药物外渗的文章。两位作者独立对每一篇文章进行了批判性评估,最终纳入了 80 篇相关研究、指南和综述。排除了讨论新生儿和儿科患者外渗事件的文章。医护人员的培训和护理方案的制定对于外渗的最佳管理非常重要。应通过专科外科医生进行及时咨询。如果需要,手术过程将包括清创术和大量冲洗。本综述根据药物对组织的毒性机制讨论了药物外渗的处理方法。它强调了密切监测患者和培训可能面临此类不良事件的医护人员的重要性。外渗仍然导致严重的发病率和死亡率。了解危险因素和实施易于获取的标准化护理方案是预防和治疗外渗的两个关键要素。

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