European Oncology Nursing Society extravasation guidelines

  • Y. Wengström
    Correspondence
    Corresponding author at: Department of Neurobiology, Care science and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. Tel.: +46705657980.
    Affiliations
    University of Stirling, Department of Nursing and Midwifery, Cancer Care Research Centre and Department of Neurobiology, Care science and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden

    University of Stirling, Department of Midwifery and Nursing, Cancer Care Research Centre, Scotland
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  • A. Margulies
    Affiliations
    Department of Oncology, Klinik und Poliklinik für Onkologie, University Hospital Zürich, Rämistrasse 100, 8091 Zürich, Switzerland
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      Summary

      An infrequent, but potential complication of chemotherapy is vesicant chemotherapy extravasation. Vesicants have the potential to cause blistering and ulceration when they extravasate from the vein or are inadvertently administered into the tissue. In 2007, the European Oncology Nursing Society published guidelines for extravasation prevention, detection, and management. Recommended management includes topical heating for plant alkaloid extravasations and topical cooling for anthracycline and other antitumor antibiotic vesicants. For treatment of antracycline extravasations topical dimethylsulfoxide (DMSO), sodium thiosulfate, and hyaluronidase have been described in the literature but due to lack of evidence to support their use as vesicant extravasation antidotes, it is recommended that these agents are studied further. Furthermore, Savene® (dexrazoxane) is the only registered drug for the treatment of antracycline extravasation. Nurses need to be aware of current evidence-based guidelines for detecting and managing vesicant extravasations and need to be prepared to administer evidence-based treatment.

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