Treatment Of Extravasation Research Articles

A rare presentation of Sintilimab-induced swelling along the vessels: Case report.

Immune-related adverse events are occasionally reported in Sintilimab treatment. This study reports a forward and reverse swelling case along the vein after infusion of Sintilimab. At present, swelling along the vascular direction during peripheral infusion are limitedly reported at home and abroad, especially when choosing a vein with thick, elastic, and good blood return. A 56-year-old male who suffered from esophageal cancer and liver cancer and received albumin-bound paclitaxel and nedaplatin chemotherapy in combination with Sintilimab immunotherapy appeared swelling along the vessel after infusion of Sintilimab. The patient was punctured 3 times. Sintilimab-induced vascular edema may be a side effect resulted from a combination of variables such as relatively poor vascular function of the patient, chemical extravasation, allergic skin reactions, venous valves, vascular intima, and diameter stenosis. Sintilimab rarely causes vascular edema only when drug allergic reaction is the underlying factor. As only a few cases of vascular edema caused by Sintilimab have been reported, causes to such a drug-induced vascular edema remained unclear. The swelling was controlled by an intravenous specialist nurse according to delayed extravasation treatment and the doctor anti-allergy treatment, but the uncertainty of repeated puncture and symptom diagnosis caused pain and anxiety to the patient and his family. The symptom of swelling was gradually relieved after the anti-allergic treatment. The patient completed the following drug infusion without discomfort after the third puncture. When the patient was discharged the next day, swelling in his both hands disappeared, and the patient had no anxiety or discomfort. The side effects of immunotherapy may accumulate over time. Early identification and appropriate nursing management are the keys to minimizing patients' pain and anxiety. To effectively treat symptoms, nurses could benefit from quickly identifying the source of swelling.

Effective Treatment of Epirubicin Extravasation with Dexrazoxane: A Case Report of Positive Clinical Outcomes

Effective Treatment of Epirubicin Extravasation with Dexrazoxane: A Case Report of Positive Clinical Outcomes

Immediate surgical treatment for massive extravasation of computed tomography contrast medium in the hand: a case report

There are no treatment guidelines for the extravasation of contrast medium. A 71-year-old man underwent coronary artery computed tomography. When contrast medium (iohexol) was injected through the right cephalic vein, massive leakage into the surrounding tissues occurred. A physical examination showed severe swelling of the hand and a prolonged capillary refill time. X-rays showed a massive accumulation of contrast medium in the hand. We immediately performed surgical treatment, including four skin incisions on the hand, subcutaneous dissection, and squeezing, which led to the removal of 50 mL of liquid. The immediate postoperative radiographic findings showed dramatic fading of most of the contrast medium. Four days postoperatively, radiography showed complete dissolution of all contrast medium, and a physical examination revealed full recovery of skin color and capillary refill time. We successfully managed massive extravasation of contrast medium in the hand with immediate surgical treatment. An immediate surgical approach for massive extravasation should be considered to achieve favorable outcomes.

184: THE INJECTION OF INTRA-ARTERIAL VASODILATOR FOR THE TREATMENT OF VASOPRESSOR EXTRAVASATION

Introduction: We described a case where vasopressor extravasation occurred and was mitigated immediately utilizing two novel techniques. This discussion highlights the importance of learning and understanding the rapid execution of treatment modalities in cases of subcutaneous extravasation of vasopressors. Description: A 67-year-old female with coronary artery disease, hypertension, anemia, and recurrent upper gastrointestinal bleeding presented to the emergency department after suffering cardiac arrest at her home. The patient was intubated and ACLS protocol was followed. The patient regained spontaneous circulation after 50 minutes. She was extremely hypotensive so a Norepinephrine infusion was started. Her hand distal to the IV became cyanotic which indicated that Norepinephrine extravasated and was causing severe vasoconstriction. We stopped the infusion of Levophed and a central line was placed.We intentionally placed an arterial line distal to the site through the brachial artery. We injected nitroprusside, a direct vasodilator, through the arterial line which is very uncommon in the ICU as medications are usually injected through the vein, not the artery. We did this in order to deliver nitroprusside directly to the forearm and hand to dilate vessels. We injected 25mg of nitroprusside and the hand immediately turned red and restored circulation. Discussion: Intracoronary nitroprusside, a vasoactive drug, has been used off-label for coronary vasospasms and is commonly used to treat congestive heart failure. Nitroprusside can effectively dilate small arteries and veins, selectively relax vascular smooth muscle and reduce peripheral vascular resistance, temporarily change hemodynamic variables, reduce blood pressure, relieve the cardiac load, and increase cardiac output.3 In the case of vasopressor extravasation, it is important to dilate the vessels in order to flush out the Norepinephrine. It is extremely difficult to perform randomized trials on vasopressor extravasation treatments due to the rare emergency nature and the non-uniformity in the methods of treatment. Although there is no literature on the use of Nitruprosside as a treatment for vasopressor extravasation, its usage in our patient’s treatment was able to successfully, and safely, salvage her hand.

Classification of Skin Injury Risk Caused by Extravasation of Electrolyte Solutions or Infusions in a Rat Model.

Cytotoxic agents are classified according to the severity of skin injury after extravasation. However, injuries caused by extravasation of noncytotoxic agents have not been sufficiently investigated, although the risk of extravasation is mentioned in medical safety information published by the Japan Council for Quality Health Care. Therefore, in this study, we focused on noncytotoxic electrolyte solutions and infusions and evaluated skin injuries during leakage using extravasation model rats. Rats were anesthetized and intradermally injected with 100 µL of an electrolyte solution or infusion. Injection lesions were macroscopically and histopathologically evaluated for extravasation injuries. Each electrolyte solution and infusion were classified into three categories (vesicants, irritants, and non-tissue-damaging agents) depending on the degree of skin injury. Similar to saline, 0.3% potassium chloride and 0.6% magnesium sulfate showed almost no injury, and 3% sodium chloride and BFLUID® caused erythema and induration. Erythema, induration, and ulceration were observed with the following: 10% sodium chloride, 2% calcium chloride, 8.5% calcium gluconate, 12.3% magnesium sulfate, MAGSENT®, FESIN®, and Intralipos®. The duration of damage with these agents was markedly prolonged. Electrolyte solutions and infusions can be classified into vesicants (10% sodium chloride, 2% calcium chloride, 8.5% calcium gluconate, 12.3% magnesium sulfate, MAGSENT®, FESIN®, and Intralipos®), irritants (3% sodium chloride and BFLUID®), and non-tissue-damaging agents (0.3% potassium chloride and 0.6% magnesium sulfate) according to their composition. The characteristic symptoms and severity of each drug extravasation revealed in this study will provide basic information for preparation of guidelines for treatment of extravasation.

The Injection of Intraarterial Vasodilator for the Treatment of Vasopressor Extravasation

A patient receiving Norepinephrine infusion through a peripheral IV experienced vasopressor extravasation. Due to an unavailability of phentolamine in the hospital, it was decided to attempt a new method of extravasation treatment through intraarterial injection of nitroprusside, restoring blood flow to the affected area. To mitigate the recurrence of vasospasms given the short half-life of nitroprusside, ropivacaine was injected. This regime successfully alleviated the extravasation-induced vasospasm and the patient recovered full function.

A clinical study of using a phentolamine alcohol wet dressing in the treatment of extravasation after a 20% fat emulsion intravenous infusion - a randomised trial

Introduction/Objective. The aim of our paper was to investigate the clinical efficacy of using a phentolamine alcohol wet dressing to treat the extravasation of an intravenously administered infusion of milk fat. This study was designed as a randomized trial, and was done at the Hengshui people?s Hospital, Hebei Province, China, from June 2019 to June 2020. Methods. In total, 300 patients were randomly divided into two groups. In the experimental group, the patients were treated using a phentolamine alcohol wet dressing, whereas in the control group, the patients were treated using a hydropathic compress with a 50% magnesium sulphate solution. The cure rate, healing time, and patient satisfaction of the two groups were compared and analyzed. Results. The cure rate of intravenous infusion extravasation was 92.67% (139/150) in the experimental group and 70.67% (106/150) in the control group (p < 0.05). In the experimental group, there were 66 patients whose cure time was less than 24 hours, 62 patients whose cure time was between 24 and 48 hours, and 22 patients whose cure time was over 48 hours. The cure time of the patients was significantly shorter in the experimental group than the control group. After treatment, in the experimental group, 67 patients were very satisfied, 52 patients were satisfied, 21 patients were generally satisfied, and 10 patients were dissatisfied; in the control group, 32 patients were very satisfied, 40 patients were satisfied, 56 patients were generally satisfied, and 22 patients were dissatisfied. The satisfaction of patients was significantly higher in the experimental group than in the control group. Conclusion. The effect of using a phentolamine alcohol wet dressing to treat the extravasation of an intravenous infusion of milk fat is significantly better than the effect of using a magnesium sulphate solution, and this type of dressing is worthy of clinical application.

Awareness of Oncology Nurses about Chemotherapy based - Extravasation Care

Objectives: To assess oncology nurses' awareness of chemotherapy-based extravasation care.
 Methodology: The study adopted a cross sectional descriptive study design. One hundred and fifty patients of both gender male and female were included in this study. Using SPSS, data analysis was performed and used to define the corresponding chi-square factor. Graphs and tables provided the details.
 Result: Total 150 participants are involved this study 71.7% were male participants and more than half 62.4% participants were registered nurses. The academic qualification of mostly participants 64.4% were diploma nurses and have 1-4 year of experience. 38.0% percent of participants were engaged in a hospital-based extravasation education program. and 62.0% were not. Only 40% of nurses want to continue their extravasation education in the hospital.
 Conclusion: Likely, the recent research serves as the basis of experience and expertise of extravasation treatment for oncology nurses. Surprisingly, nurses' understanding of management methods was woefully lacking. This may have an effect on the level of care given to patients with the aid of extravasation Education, lectures, and conferences are held on a regular basis.

Elaboration and validation of an algorithm for treating peripheral intravenous infiltration and extravasation in children.

Objective:to elaborate and validate the content and appearance of an algorithm for treating infiltration and extravasation of non-chemotherapy drugs and solutions administered to children.Method:a methodological study of the technology formulation and validation type. To elaborate the algorithm, a bibliographic review was carried out to list the scientific evidence on the treatment of infiltration and extravasation. Content and appearance validation was in charge of 14 specialists in pediatric nursing, using the Delphi technique, adopting a value equal to or greater than 0.80 as Content Validation Index.Results:the algorithm was validated in the third evaluation by the judges, reaching a Global Content Validation Index of 0.99, being composed by the perception of the occurrence of the complication; discontinuation of intravenous therapy infusion; verification of signs and symptoms; measurement of edema; application of an infiltration and extravasation assessment scale and conduits to be used according to the characteristics of the fluid administered and the type of complication.Conclusion:the algorithm was validated and can be used in a practical and objective way by health professionals, in order to promote safety in the care of hospitalized children, with regard to reducing harms caused by infiltration and extravasation.

The consequences of delayed treatment in doxorubicin extravasation

Doxorubicin (Adriamycin) is an anthracycline chemotherapy agent used for the treatment of several cancers including haematological malignancies. Extravasation is a well-recognized and possibly serious complication of administered intravenous therapies, especially in chemotherapeutic agents. Drug extravasation into the surrounding tissue has been estimated to occur in 0.1–6% of patients that receive chemotherapy. Signs of the injury can be subtle, and in case of delayed detection (> 6 h) and treatment, doxorubicin extravasation can result in substantial tissue damage with significant loss of function depending on the location of injury. Other consequences include pain, physical defect, psychological distress, cost of hospitalization and treatment and more extensive damage to skin and underlying tissue. In this article, we will discuss a case of delayed treatment of doxorubicin extravasation from a Venflon venous line at the dorsum of the hand with severe tissue necrosis as a result. Successful surgical reconstruction of the resulting substantial tissue damage using a SCIAP flap 25 days following the extravasation is described. Level of evidence: Level V, risk study.

Extravasation of [177Lu]Lu-DOTATOC: case report and discussion

BackgroundIn the case of extravasation of radioactive drugs used in peptide-receptor radionuclide therapy of neuroendocrine tumors, or in radionuclide therapy in general, rapid action is important to reduce or avoid complications. The literature on extravasation of drugs for radionuclide therapy is sparse. Based on the present case, we discuss handling and consequences of extravasation. Further, we demonstrate that dosimetry can aid in judging if the treatment of neuroendocrine tumors is satisfactory even after extravasation.Case presentationA case of extravasation of [177Lu]Lu-DOTATOC with a treatment strategy involving exercise and elevation of the affected arm and application of a compression bandage and heating is reported. Redistribution of the drug is verified and quantified by whole-body imaging and quantitative SPECT/CT and measurements of the dose rate at contact with the injection site. [177Lu]Lu-DOTATOC was redistributed to tumors and organs within 1 day. The patient did not report any discomfort during or after hospitalization, and no side effects related to extravasation were observed. Quantitative SPECT/CT scans at the subsequent treatment cycle of the same patient were analyzed for a comparison between the treatments. Dosimetry showed the treatments were similar with respect to the kidney and tumor absorbed doses. The radiation dose to the epidermal basal layer near the injection site was estimated and found to be consistent with the lack of side effects.ConclusionsThe treatment of extravasation was successful, and the redistribution of the drug can be easily verified through measurement of the dose rate at contact with the skin. From the results of dosimetry, it was assessed that no change of the treatment course was necessary to compensate for a possibly incomplete treatment as a result of the extravasation.

Managing chemotherapy extravasation in totally implantable central venous access: Use of subcutaneous wash-out technique.

Totally implanted venous access is widely used in chemotherapy administration. With over 1 million intravenous chemotherapy infusions given worldwide each day, complications are frequent. Accidental cases of extravasation in the presence of a catheter are rare yet very serious and may require discontinuation of chemotherapy. The aim of this study was to evaluate the feasibility and efficacy of the subcutaneous wash-out technique for chemotherapy extravasation treatment. We retrospectively reviewed the medical charts of patients who had received chemotherapy and sustained extravasation in our hospital between October 2013 and October 2016. Subcutaneous wash-out treatments were carried out exclusively, without the application of antidotes or the use of specific antidotes. We documented seven cases of chemotherapy extravasation. Two cases were treated with antidotes and suffered necrosis in the following weeks. The five patients treated using subcutaneous wash-out had no necrosis and had a steady decrease in the inflammatory reaction of the cutaneous and subcutaneous soft tissues. For these five patients, chemotherapy was restarted within 1 month following extravasation. This study would argue for the feasibility and effectiveness of subcutaneous wash-out in the treatment of chemotherapy extravasations.

Extravasation of Noncytotoxic Drugs.

Objective: Commonly used drugs may be dangerous in case of extravasation. The lack of information from health care teams can lead to delays in both diagnosis and treatments. This review aims at alerting health care professionals about drugs and risk factors for extravasation and outlines recommendations for the diagnosis and treatment of extravasation. Data Source: A literature search of MEDLINE/PubMed, Scopus, the Cochrane Library, and Google Scholar was performed from 2000 to December 2019 using the following terms: extravasation, central venous line, peripheral venous line, irritant, and vesicant. Study Selection and Data Extraction: Overall, 140 articles dealing with drug extravasation were considered potentially relevant. Each article was critically appraised independently by 2 authors, leading to the inclusion of 80 relevant studies, guidelines, and reviews. Articles discussing incidents of extravasation in the neonatal and pediatric population of patients were excluded. Data Synthesis: Training of health care teams and writing care protocols are important for an optimal management of extravasations. A prompt consultation should be achieved by a specialist surgeon. The surgical procedure, if necessary, will consist of wound debridement followed by an abundant lavage. Relevance to Patient Care and Clinical Practice: This review discusses the management of drug extravasations according to their mechanism(s) of toxicity on tissues. It highlights the importance of a close monitoring of patients and the training of health care teams likely to face this type of adverse event. Conclusions: Extravasations still contribute to significant morbidity and mortality. A good knowledge of risk factors and the implementation of easily and quickly accessible standardized care protocols are 2 key elements in both prevention and treatment of extravasations.

Evaluation of the Effect of Chemotherapeutic Drug Training on Mobile Terminal for Neuro-Oncology Nurses Based on Kirkpatrick’s Model

Background: Since there has been training, there has been discussion about the effect of training. But training evaluation is not systematic until Kirkpatrick came up with the training evaluation model in 1959. At present, the prevailing model in the systematic summary of training evaluation is still The Kirkpatrick’s model. This model was further improved in 1994, more responsive to contemporary needs, and thus widely used all over the world. At the beginning, it was widely used in human resource management of enterprises. In recent years, this model has been gradually used in the medical field to evaluate the effect of medical training. The Kirkpatrick’s model has a systematic, integrated and persuasive evaluation system for trainees. It has good effects in the pre-service nurse training, the professional image and code of conduct nurses training, and the geriatric nurse training. At present, there are few studies on the chemotherapeutic drug training of neurologist nurses in China. In clinical work, nurses’ cognitive and practical behaviors of chemotherapeutic drug protection and drug extravasation prevention and treatment are insufficient. It directly harms the health of nursing staff and increases the complications of chemotherapy, increases pain of tumor patients, delays or interrupts chemotherapy, and aggravates the economic burden of patients. Especially, Chemotherapeutic drugs for neuro-oncology have particularity and necessity of urgent training. Objective: To investigate the effect of chemotherapeutic drug training through mobile terminal for neuro-oncology nurses based on the Kirkpatrick’s model. Methods: The training content and evaluation questionnaire for chemotherapeutic drugs were designed by nursing management personnel and senior nurses in our department according to the guidelines and common diseases requiring chemotherapy in the department. The content includes the basic knowledge of neuro-oncology chemotherapy, pharmacological knowledge, toxic and side effect of chemotherapy, etc., which are regularly pushed through the mobile terminal-WeChat. Forty nurses participated in the training and the effect is evaluated by Kirkpatrick’s model. Result: After the training, 100% of nurses were satisfied with the training content and 97.5% with the training form. The scores of nurses in learning level such as basic pharmacological knowledge, drug configuration and exposure, drug treatment and infusion, observation of toxic and side effects, and treatment of drug extravasation were significantly higher than those before the training (P

Epidermal Necrosis of Forearm and Wrist due to Extravasation of Sodium Bicarbonate and Application of Epidermal Growth Factor for Therapy in Extremely Low Birth Weight Infant

Extravasation occurs when an intravenous drug is inadvertently administered into the perivascular space or subcutaneous tissue. This can have various consequences, from local irritation to severe tissue loss. Extravasation occur more frequently in neonatal populations, especially in younger gestational ages and with lower birth weights. There is no established method of treatment for extravasation. Conservative treatments such as saline wash, wet dressing, hyaluronidase, and hydrogel dressing should be performed. Recently, two full-term newborns have been reported to successfully treat skin necrosis with recombinant human basic fibroblast growth factor. We report for the first time that extravasation in extremely very low birth weight infants can be successfully treated with recombinant human epidermal growth factor.

Investigation on the mode of action of the traditional chinese medical prescription-yiqihuoxue formula, an effective extravasation treatment for cerebral vascular microemboli in ApoE-/- mice

Objective: The objective of this study was to investigate the mechanisms underlying anti-embolism and extravasational effects of traditional Chinese medical prescription YiqiHuoxue (YQHX) formula in ApoE-/-mice with cerebral vascular microemboli. Materials and Methods: An ApoE-/-mice model with microemboli was developed by infusing fluorescently labeled heterologous fibrin-rich microparticles into the internal carotid artery of ApoE-/-gene knockout male mice through the common carotid artery. Before microemboli injection, the animals were randomly divided into four groups of 10 animals, treated daily for 6 weeks by intragastric administration: The ApoE-/-control group (physiological saline, 0.2 mL/10 g/d), YQHX group (0.2 ml/10 g/d), clopidogrel group (3 mg/kg/d), and atorvastatin group (3 mg/kg/d); a further group was constituted of normal male C57BL/6J mice (with the same genetic background as ApoE-/-mice; normal control group; no treatment; microemboli injection). The mice in each microemboli group were divided into three subgroups, the 2-h, 24-h, and 72-h subgroups, corresponding to the time after microemboli injection. Two hours (or 24 h or 72 h) after microemboli injection, the changes in aortic intima and brain tissue were analyzed by histopathology, the amounts of fluorescent emboli being measured by fluorescence microscopy image analysis. Comparison points included the microemboli induced loss of aorta functions and pathological changes, atherosclerotic plaque, brain ultrastructure and functions, and embolus extravasation. Results: Loss of aorta functions and adverse pathological changes, atherosclerotic plaque, serious damage in brain ultrastructure and functions, and reduced thrombus elimination were obviously serious in microemboli injected ApoE-/-mice. These symptoms were significantly relieved by the YQHX pretreatment: (i) the ratio of thrombus accumulation was increased with a significant decrease in thrombus extravasation in ApoE-/-mice, while YQHX induced an increased thrombus extravasation; (ii) the degree of aortic intimal thickening and brain tissue structural disorders were significantly increased in ApoE-/-mice, but overtly inhibited in the YQHX group; (iii) YQHX restored cell viability and homeostasis in the brain; (iv) YQHX regulated the expression of pro- and anti-inflammatory cytokines in the aorta; and (v) YQHX reduced cortical nerve nuclei pyknosis, edema, liquefaction, and necrosis induced by brain hypoxia, especially in the 24 h and 72 h groups. Conclusions: These findings indicate that the protective effects of YQHX on the brain against microemboli-induced injury may be attributed to the activation of extravasation mechanisms, which are involved in the cerebrovascular injury pathway and constitutively important in the progression of ischemic stroke.

Multiple Stab Incisions and Evacuation Technique for Contrast Extravasation of the Hand and Forearm.

Extravasation of intravenous contrast agents in the hand and forearm during computed tomography scanning is rising with the use of automated pressure injectors. The main concern in such a situation is progression to acute compartment syndrome and necrosis of the overlying skin. Management has been mainly nonsurgical comprising upper limb elevation and orthosis, with surgical techniques such as liposuction and saline evacuation mainly used for large volume (>50 mL) extravasations. We have developed a technique of multiple stab incisions and drainage for the treatment of contrast extravasations.

Treatment of extravasation injuries in infants and young children: a scoping review and survey.

Extravasation injuries are caused by unintended leakages of fluids or medicines from intravenous lines, but there is no consensus on the best treatment approaches. To identify which treatments may be best for treating extravasation injuries in infants and young children. Scoping review and survey of practice. Children aged < 18 years with extravasation injuries and NHS staff who treat children with extravasation injuries. Any treatment for extravasation injury. Wound healing time, infection, pain, scarring, functional impairment, requirement for surgery. Twelve database searches were carried out in February 2017 without date restrictions, including MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus and EMBASE (Excerpta Medica dataBASE). Scoping review - studies were screened in duplicate. Data were extracted by one researcher and checked by another. Studies were grouped by design, and then by intervention, with details summarised narratively and in tables. The survey questionnaire was distributed to NHS staff at neonatal units, paediatric intensive care units and principal oncology/haematology units. Summary results were presented narratively and in tables and figures. The evidence identified in the scoping review mostly comprised small, retrospective, uncontrolled group studies or case reports. The studies covered a wide range of interventions including conservative management approaches, saline flush-out techniques (with or without prior hyaluronidase), hyaluronidase (without flush-out), artificial skin treatments, debridement and plastic surgery. Few studies graded injury severity and the results sections and outcomes reported in most studies were limited. There was heterogeneity across study populations in age, types of infusate, injury severity, location of injury and the time gaps between injury identification and subsequent treatment. Some of the better evidence related to studies of flush-out techniques. The NHS survey yielded 63 responses from hospital units across the UK. Results indicated that, although most units had a written protocol or guideline for treating extravasation injuries, only one-third of documents included a staging system for grading injury severity. In neonatal units, parenteral nutrition caused most extravasation injuries. In principal oncology/haematology units, most injuries were due to vesicant chemotherapies. The most frequently used interventions were elevation of the affected area and analgesics. Warm or cold compresses were rarely used. Saline flush-out treatments, either with or without hyaluronidase, were regularly used in about half of all neonatal units. Most responders thought a randomised controlled trial might be a viable future research design, though opinions varied greatly by setting. Paucity of good-quality studies. There is uncertainty about which treatments are most promising, particularly with respect to treating earlier-stage injuries. Saline flush-out techniques and conservative management approaches are commonly used and may be suitable for evaluation in trials. Conventional randomised trials may be difficult to perform, although a randomised registry trial may be an appropriate alternative. The National Institute for Health Research Health Technology Assessment programme.

Application effects of Sanyrene on the drug extravasation induced by intravenous drip of potassium chloride in adults

Objective To investigate the nursing effects of Sanyrene in the drug extravasation induced by intravenous drip of potassium chloride in adults. Methods A total of 72 patients with drug extravasation caused by intravenous drip pf potassium chloride in Chinese PLA General Hospital from April 2016 to April 2017 were selected as study objects and divided into the control group and the experimental group according to the order of admission, 36 cases respectively. Patients in the control group were treated with magnesium sulfate, while patients in the experimental group were treated with Sanyrene. After the treatment, both groups were given comprehensive nursing intervention. The total clinical therapeutic efficiency, incidence of complications and patients' nursing satisfaction rate were compared between two groups. Results The total clinical therapeutic efficiency and patients' satisfaction rate in the experimental group were significantly higher than those in the control group (P<0.05) . The incidence of complications in the experimental group was significantly lower than that in the control group (P<0.05) . Conclusions The application of Sanyrene in the treatment of drug extravasation induced by intravenous drip of potassium chloride in adults has significant therapeutic effect. The combination of Sanyrene with comprehensive nursing intervention can help to shorten the clinical symptom remission time, improve nursing satisfaction, and reduce the incidence of complications of patients, which is worthy of clinical promotion. Key words: Nursing care; Sanyrene; Intravenous drip of potassium chloride; Drug extravasation

Extrahepatic Collateral Artery Extravasation in Patients with Ruptured Hepatocellular Carcinoma

This report describes 3 patients with previously untreated hepatic tumors who underwent embolization for the treatment of extravasation from extrahepatic arteries. Although development of extrahepatic collateral blood supply is well known, its importance in the presentation of rupture of liver tumors may be underrecognized. Findings that suggest bleeding from extrahepatic arteries include a discrepancy in the pattern of extravasation on computed tomography vs hepatic angiography and a lack of stabilization of vital signs after embolization of hepatic arteries. To achieve successful hemostasis in embolization, the potential involvement of such extrahepatic arteries should be accurately recognized, suggestive imaging findings considered, and the occult vessels selected and embolized.