Servicio de Farmacia, Hospital General Universitario de Elche, Elche, Comunidad Valenciana, Spain.
Servicio de Farmacia, Hospital Universitari i Politècnic La Fe, Valencia, Comunidad Valenciana, Spain.
J Oncol Pharm Pract. 2024 Jan;30(1):67-77. doi: 10.1177/10781552231167873. Epub 2023 Apr 9.
Extravasation is a potentially severe complication of intravenous administration of antineoplastic drugs. The limited data makes it difficult to develop an optimal management scheme. The objective of this study is to describe the clinical practice in the extravasation management of antineoplastic agents in Spanish centers.
An online survey was distributed to oncology pharmacists using the email distribution list of the Spanish Society of Hospital Pharmacists. Respondents were surveyed on the standard operational protocol (SOP) of extravasation, tissue damage risk classification, and specific measures of extravasation management.
A total of 68 surveys were completed. A specific extravasation SOP was available in 82.4% centers. The pharmacist participates in the authorship (100%) and actively collaborates in extravasation management (76.5%). A tissue damage risk classification based on the three categories was mostly adopted (48.2%) and 73.2% applied specific criteria based on concentration and/or extravasated volume. Extravasation management was mainly performed with the application of physical measures and/or antidotes (91.2%). High variability in the choices of pharmacological and/or physical measures recommended is outstanding.
The results of this study highlight the involvement of Spanish pharmacists in extravasation management, the application of physical measures and/or pharmacological measures as the method of choice in extravasation management, as well as the existing discrepancies in tissue damage risk classification and management recommendations.
静脉注射抗肿瘤药物时发生外渗是一种潜在的严重并发症。由于数据有限，制定最佳管理方案具有一定难度。本研究旨在描述西班牙各中心在抗肿瘤药物外渗管理方面的临床实践。
采用西班牙医院药剂师学会的电子邮件分发列表，向肿瘤药剂师在线分发调查问卷，调查内容包括外渗管理的标准操作流程（SOP）、组织损伤风险分类和具体外渗管理措施。
共完成 68 份调查问卷。82.4%的中心有特定的外渗 SOP。药剂师参与 SOP 的制定（100%），并积极参与外渗管理（76.5%）。大多数中心采用基于三类的组织损伤风险分类（48.2%），并根据浓度和/或外渗量应用特定标准（73.2%）。主要采用物理措施和/或解毒剂进行外渗管理（91.2%）。推荐的药理和/或物理措施的选择存在很大差异。
本研究结果突出了西班牙药剂师在处理外渗方面的参与，应用物理措施和/或药理措施作为外渗管理的首选方法，以及在组织损伤风险分类和管理建议方面存在的差异。
