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Extravasation and infiltration: under-recognised complications of intravenous therapy

04 April 2024
Volume 33 · Issue 7


Occasionally, the administration of intravenous (IV) therapies can go wrong. Infiltration or extravasation is a complication when a drug or IV therapy leaks into the tissues surrounding the vascular access device. Extravasation can cause serious and often life-changing injuries. Extravasation is often associated with systemic anti-cancer therapy but non-chemotherapy drugs have been reported as having a greater risk of serious complications. This study outlines the first UK Infusion unit evaluation of the ivWatch infusion monitoring device which was undertaken from August 2023 to January 2024. Out of 2254 infusions monitored with ivWatch, the device prevented 122 cases of infiltration and extravasation from causing any harm to the patient, corresponding to a 5.4% ‘check IV’ notification rate.

Intravenous (IV) therapy is an essential aspect of modern healthcare and commonly used within the NHS. Its advantages include improved patient outcomes and, in some cases, the IV route is the preferred option because it ensures consistent drug bioavailability and reliable therapeutic drug levels in the blood (Price and Patel, 2020). Unfortunately, the use of IV therapies is not without risks. While the benefits usually outweigh such risks, all staff involved in the administration of such therapies need a sound knowledge of potential complications. Infection associated with IV therapy and vascular access devices (VADs) is well known (Munoz-Mozas, 2023) and great efforts have been taken throughout the NHS to mitigate this risk in recent years. However, there are some complications that are less recognised and well known, including infiltration and extravasation.

Infiltration and extravasation are complications often associated with chemotherapy agents; however, non-chemotherapy drugs have been reported as having a greater rate and risk of serious complications (NHS Resolution (NHSR), 2022).

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