Abstract
BackgroundExtravasation injury remains an important cause of iatrogenic injury in neonatal intensive care. This study aims to describe the current approach to extravasation injury (EI) prevention and management in Neonatal Intensive Care Units (NICUs) in Australia and New Zealand.MethodsA literature review regarding extravasation injury in the newborn was carried out to inform questionnaire design. An internet-based survey was then conducted with the clinical directors of the 27 tertiary NICUs in Australia and New Zealand.ResultsThe survey received a 96% response rate. Approximately two thirds of Australian and New Zealand NICUs have written protocols for prevention and management of extravasation injury. Considerable practice variation was seen for both prevention and treatment of EI. 92% of units had experienced cases of significant EI.ConclusionsAustralian and New Zealand tertiary neonatal units clearly recognise EI as an important cause of iatrogenic morbidity and mortality. Significant variation still exists among units with regards to guidelines for both prevention and management of EI. We recommend that neonatal staff should remain vigilant, ensuring that guidelines for the prevention and treatment of EI are available, and rigorously followed.
Highlights
Extravasation injury remains an important cause of iatrogenic injury in neonatal intensive care
The use of intravenous (IV) access for provision of nutrition and medication is essential in modern neonatal intensive care
Extravasation injury as a complication of neonatal intensive care remains an important cause of iatrogenic morbidity and mortality. 92% of units surveyed reported having experienced a significant extravasation incident
Summary
Extravasation injury remains an important cause of iatrogenic injury in neonatal intensive care. This study aims to describe the current approach to extravasation injury (EI) prevention and management in Neonatal Intensive Care Units (NICUs) in Australia and New Zealand. The use of intravenous (IV) access for provision of nutrition and medication is essential in modern neonatal intensive care. Neonatal veins are small and fragile, and intravenous lines are often required for long periods of time. EI occurs when fluid from an IV line leaks into the surrounding tissues or other extra-vascular space. Tissue damage occurs as a result of differences in physiochemical characteristics, including pH and osmolarity, between the extravasate substance and the host tissue [1]. Depending on IV line location (central or peripheral), the infiltrate can cause damage potentially resulting in: skin loss, tendon and
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