Extravasation (intravenous)

Extravasation (intravenous)
Classification and external resources
MeSH D005119

Extravasation is the leakage of intravenously (IV) infused potentially damaging medications into the extravascular tissue around the site of infusion. The leakage can occur through brittle veins in the elderly, through previous venipuncture access, or through direct leakage from wrongly positioned venous access devices. When the leakage is not of harmful consequence it is known as infiltration. Extravasation of medication during intravenous therapy is an adverse event related to therapy that, depending on the medication, amount of exposure, and location, can potentially cause serious injury and permanent harm, such as tissue necrosis. Milder consequences of extravasation include irritation, characterized by symptoms of pain and inflammation, with the clinical signs of warmth, erythema, or tenderness.


Complications related to extravasation are possible with any medication. Since Vesicants are blistering agents, extravasation may lead to irreversible tissue injury.

Extravasation is particularly serious during Chemotherapy, since chemotherapy medications are highly toxic.

In recent years, healthcare professionals are becoming more aware of this problem.[1][2][3][4][5]

Treatments and techniques

The best "treatment" of extravasation is prevention. Depending on the medication that has extravasated, there are potential management options and treatments that aim to minimize damage, although the effectiveness of many of these treatments has not been well studied.[6] In cases of tissue necrosis, surgical debridement and reconstruction may be necessary. The following steps are typically involved in managing extravasation:

Pain management and other measures

Prevention of extravasation in hospitals

Examples of vesicant medicinal drugs

List of vesicant and irritant medications:[6][11]

Cytotoxic drugs

Non-cytotoxic drugs

See also


  1. Sauerland C, Engelking C, Wickham R, Corbi D (Nov 2006). "Vesicant extravasation part I: Mechanisms, pathogenesis, and nursing care to reduce risk". Oncol Nurs Forum. 33 (6): 1134–41. doi:10.1188/06.onf.1134-1141.
  2. Wickham R, Engelking C, Sauerland C, Corbi D (Nov 2006). "Vesicant extravasation part II: Evidence-based management and continuing controversies". Oncol Nurs Forum. 33 (6): 1143–50. doi:10.1188/06/onf.1143-1150.
  3. Goolsby TV, Lombardo FA (Feb 2006). "Extravasation of chemotherapeutic agents: prevention and treatment". Semin Oncol. 33 (1): 139–43. doi:10.1053/j.seminoncol.2005.11.007.
  4. Ener RA, Meglathery SB, Styler M (Jun 2004). "Extravasation of systemic hemato-oncological therapies". Ann Oncol. 15 (6): 858–62. doi:10.1093/annonc/mdh214.
  5. Schrijvers DL (2003). "Extravasation: a dreaded complication of chemotherapy". Ann Oncol. 14 (Suppl 3): iii26–30.
  6. 1 2 3 Chemotherapy vesicants, irritants, and treatment for extravasation
  7. Shaqdan K; et al. (2014). "Incidence of contrast medium extravasation for CT and MRI in a large academic medical centre: A report on 502, 391 injections". Clinical Radiology. 69: 1264–1272. doi:10.1016/j.crad.2014.08.004.
  8. For more information on substance-specific measures, see, for example, the textbook "Extravasation of cytotoxic agents" (Authors: I Mader et al., Springer Publishing House)
  9. Mouridsen HT, Langer SW, Buter J, Eidtmann H, Rosti G, de Wit M, Knoblauch P, Rasmussen A, Dahlstrom K, Jensen PB, Giaccone G (Mar 2007). "Treatment of anthracycline extravasation with Savene (dexrazoxane): results from two prospective clinical multicentre studies". Ann Oncol. 18 (3): 546–50. doi:10.1093/annonc/mdl413.
  10. Infusion Nurses Society, Infusion Nursing 3rd ed 2010
  11. www.IVACCESS.com
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