Management of the extravasation of anti-neoplastic agents

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• 作者：J. Boulanger ; A. Ducharme ; A. Dufour ; S. Fortier ; K. Almanric
• 关键词：Extravasation ; Chemotherapy ; Management ; Antidote
• 刊名：Supportive Care in Cancer
• 出版年：2015
• 出版时间：May 2015
• 年：2015
• 卷：23
• 期：5
• 页码：1459-1471
• 全文大小：399 KB
• 参考文献：Infusion nursing standards of practice. J Infus Nurs 341: pp. S1-S110
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  Chemotherapy extravasation guideline. WOSCAN, Glasgow
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Nursing
  Nursing Management and Research
  Pain Medicine
  Rehabilitation Medicine
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-7339

文摘

Background Extravasation is a potentially severe complication that can occur during the administration of chemotherapy. The scarcity of evidence available makes it difficult to develop an optimal management scheme. The purpose of this guideline is to review the relevant scientific literature on the prevention, management, and treatment of extravasation occurring during the administration of chemotherapy to cancer patients. Method A scientific literature review was conducted using the PubMed search tool. The period covered was from database inception to April 2014, inclusively. Since the literature on extravasation treatment is often empirical, anecdotal, and controversial, the review also identified clinical practice guidelines and expert consensuses published by relevant international organizations and cancer agencies. Results Identification of potential risk factors and preventive measures can reduce the risk of extravasation. Recognition and management of symptoms are crucial in patients with this complication. Provision of adequate instruction to personnel responsible for administering chemotherapy and to patients on recognizing symptoms, preventing, and managing extravasation is essential. Extravasation can be treated with dry warm or cold compresses and various antidotes such as dimethyl sulfoxide, dexrazoxane, hyaluronidase, or sodium thiosulfate, depending on the agent that has caused extravasation. Patient monitoring to assess the progression or regression of symptoms and to thus take the appropriate measures is necessary. Conclusion Several strategies must be established to ensure that extravasation is recognized and properly managed. Given the evidence available at this time, the Comité de l’évolution des pratiques en oncologie (CEPO) has made recommendations for clinical practice in Quebec.