Neonatal extravasation injury

Because the stratum corneum of newborns is thinner than that of adults, the defense system is weaker, and the skin moisture content is high, accounting for about 13% of the water value in the body. Therefore, skin care and wound management are difficult, and even life-threatening if not handled properly. Neonatal infusion extravasation injury (PIVIE) is one of the most common types of hospital-acquired injury, with the potential to cause long-term disfigurement or loss of function. How to reduce the occurrence of such situations? Come and follow me to take a look.

What is fluid extravasation?

Extravasation is the entry of a noncaustic drug or solution into surrounding tissues rather than into normal vascular access due to inadvertent infusion administration. The incidence of neonates affected by extravasation injuries ranges from 23 % to 63 %.

Pathological and Physiological Changes of Fluid Extravasation :

The tip of the indwelling needle punctures the vessel wall, causing infusion fluid to enter the perivascular tissue.

Although the needle tip is indwelling in the blood vessel, the constriction of the vein caused by the infusion fluid or the irritation of the tip against the vessel wall creates a backward pressure that allows the infusion fluid to leak through the eye of the needle left when the catheter was placed.

Neonatal PIVIE formation factors:

1. The immature skin, subcutaneous tissue, and vasculature of newborns are thinner and more fragile than those of older adults. Thin skin, immature stratum corneum, vulnerable to damage, easy to cause infection, especially premature infants with thin skin and less red fat.

2. Frequent replacement of vascular access device sites can cause further difficulties for pediatric patients, and the use of adhesive tape for fixation can cause adhesive damage to the skin of newborns.

3. The inability of newborns to express specific pain effectively may be a problem with a malfunctioning vascular access device.

Factors Affecting Wound Severity:

1. Extravasation The amount of fluid that leaks into the subcutaneous tissue compartments.

2. site of extravasation

3. Time of exposure to extravasated fluid

4. Osmotic pressure and pH of extravasated fluid

Blood or fluid leakage from the insertion site may be observed early in extravasation. If extravasation is not detected early, it can lead to more serious skin damage. These include whitening of the skin, changes in the size of the area of the blisters, and the formation of pain and wounds.

How to prevent PIVIE?

1. Dressings such as transparent dressings. Its unique characteristics can be used for the acute prevention of extravasation injuries. Catheter Transparent Dressing's ultra-high breathability imported ultra-thin frosted polyurethane (PU) is close to the skin in color, transparent, breathable, and waterproof. It can be fully attached to the skin, allowing easy observation of injection sites and wounds. It is convenient to observe the injection site and wound condition. It reduces tissue edema and inflammation, even in closed injuries such as sprains and bruises. Additionally, the ability of the dressing to stay in place for several days makes it a cost-effective treatment option. And the product is safe and easy to paste, convenient to operate.

2. And documentation of findings in the clinical record will ensure early detection of changes.

3. Record infusion set baseline alarm limits and pressure records hourly to detect and act on elevated pressures early.

For more information on Innomed® transparent dressing, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

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Editor: kiki Jia

Date: February 15, 2023