Infusion Site Reactions: Classification in the Setting of Fosaprepitant Administration With Chemotherapy.
Alexa N Segna, Roberta H Baron, Bevin Cohen
PMID 33216065WHAT IT FOUND
Most suspected infusion site reactions after fosaprepitant were not true extravasations.
In a chart review, only six of 110 sampled patients showed signs like blistering or oozing, while the rest had milder symptoms like swelling or redness.
Key findings
01Of 15,667 patients receiving fosaprepitant with chemotherapy, 460 (3%) had documentation for suspected extravasation.
02In a random sample of 110 patients with suspected extravasation, only six had documented signs consistent with extravasation (blistering or oozing), while the majority had non-extravasation symptoms like swelling and redness.
03The estimated incidence of true extravasation in the cohort was about 0.16%, which is slightly higher than the 0.04%–0.09% reported in other studies.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The route of administration (peripheral IV vs. central line) was not known for all patients, so the study could not check if the type of line affected reaction risk. There is no universally accepted standard for distinguishing extravasation from other infusion reactions, so the classification relied on the institution's specific nursing policy. The incidence estimate for the whole cohort was extrapolated from a sample of only 110 charts out of 460 suspected cases.
Declared interests
The study was conducted at Memorial Sloan Kettering Cancer Center. No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that a patient with swelling or redness after fosaprepitant has suffered a tissue-damaging extravasation. The study found that true extravasation (marked by blistering or oozing) occurred in only a small fraction of suspected cases, though all suspected cases require monitoring.