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Chemotherapy extravasation from implanted ports.

L Schulmeister1, D Camp-Sorrell

  • 1Louisiana State University Health Sciences Center, New Orleans, USA.

Oncology Nursing Forum
|April 29, 2000
PubMed
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Extravasation from implanted ports, a risk during chemotherapy, can stem from needle issues, thrombus, vessel perforation, or catheter fracture, potentially causing severe tissue damage. Proper needle placement and securing are crucial to prevent these complications.

Area of Science:

  • Oncology
  • Vascular Access Devices
  • Patient Safety

Background:

  • Implanted ports are widely used for long-term chemotherapy administration.
  • Extravasation, the leakage of infusate into surrounding tissues, is a significant complication.
  • Vesicant chemotherapy agents pose a particular risk due to their potential for severe tissue injury.

Purpose of the Study:

  • To identify and describe the four primary mechanisms of extravasation from implanted ports.
  • To highlight the potential severity of tissue damage resulting from extravasation.
  • To inform risk-management strategies for preventing and managing extravasation events.

Main Methods:

  • Comprehensive literature review including journal articles and textbooks.
  • Analysis of medical records and deposition data.

Related Experiment Videos

  • Inclusion of authors' personal experiences and photographic evidence.

    • Main Results:

    • Four principal causes of extravasation identified: incomplete needle placement/dislodgement, thrombus/fibrin sheath formation, superior vena cava perforation, and catheter fracture.
    • Tissue injury severity ranges from mild to severe, potentially necessitating interventions like mastectomy for chest wall necrosis.
    • Extravasation is a recognized risk associated with implanted port use for chemotherapy.

    Conclusions:

    • Administering vesicants requires confirmation of blood return and secure needle placement within the port septum.
    • Risk-management strategies are essential, including patient education on extravasation risks and prevention.
    • Developing clear policies for managing port-related extravasations is crucial for patient safety and mitigating litigation risks.