Bithal Parmod K, Jan Ravees, Kalou Mohammed M, Bafaquh Mohammad S
Department of Anesthesiology and Perioperative Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
Department of Neurosurgery, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia.
Saudi J Anaesth. 2022 Oct-Dec;16(4):463-465. doi: 10.4103/sja.sja_786_21. Epub 2022 Sep 3.
Extravasation injury (EVI) is an iatrogenic complication of venous cannulation. Usually innocuous but occasionally it engenders sequelae. Its severity is determined by various physicochemical properties of infusate. A 50-year-old patient developed leg EVI from crystalloids infused through a pressurized digital infuser (PDI), likely from cannula tip displacement during positioning for craniotomy. We ignored checking gravity-aided free-fluids flow before switching on PDI. Following surgery, the patient had an edematous leg with bullae and epidermal peelings from severe extravasation and burns, respectively. Doppler revealed patent leg arteries. Therefore, EVI was conservatively managed, with complete recovery. Apparently, increased local tissue pressure from extravasation produced conditions of peripheral circulation sufficiency predisposing the leg to thermal injury from the forced-air warmer. On inspecting PDI postoperatively, its upper-pressure alarm limit was 300 mmHg, which prevented it from sounding alarm during extravasation.
外渗性损伤（EVI）是静脉置管的一种医源性并发症。通常无害，但偶尔会产生后遗症。其严重程度由输注液的各种物理化学性质决定。一名50岁患者因通过加压数字输注器（PDI）输注晶体液而发生腿部EVI，可能是由于开颅手术定位期间套管尖端移位所致。我们在开启PDI之前忽略了检查重力辅助下的自由液体流动情况。手术后，患者腿部出现水肿，分别因严重外渗和烧伤出现水泡和表皮脱落。多普勒检查显示腿部动脉通畅。因此，对EVI进行了保守治疗，患者完全康复。显然，外渗导致的局部组织压力增加产生了外周循环充足的情况，使腿部易受强制空气暖器的热损伤。术后检查PDI时发现，其高压报警极限为300 mmHg，这导致在外渗期间未发出警报。
