1/40. skin necrosis induced by extravasation of glycerol-containing peripheral parenteral nutrition formulation.Administration of parenteral nutrition (PN) via a peripheral vein has gained support over the last decade due to serious complications associated with central venous catheterization. Extravasation and tissue necrosis have been reported with both peripheral and central dextrose-containing PN formulations. The following case report represents the first documented case of skin necrosis due to extravasation of a glycerol-containing PN formulation. Our patient's condition resolved with local therapy such as elevation of the affected extremity and cold compresses. Routine evaluation of proper catheter placement is recommended to prevent this serious morbid event, while various treatment recommendations are outlined for severe injuries that do not respond to general measures such as cold compresses.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
2/40. oxacillin-induced tissue necrosis.OBJECTIVE: To report a case of oxacillin-induced tissue necrosis in which recommended concentration guidelines for dilution and administration were used. oxacillin concentration data, potential risk factors, and treatment options for extravasation injuries are also briefly reviewed. CASE SUMMARY: oxacillin was infused peripherally by infusion pump in a 79-year-old white woman as prophylactic antibiotic coverage for permanent pacemaker placement. oxacillin extravasation occurred after the second postoperative dose. A dime-sized area of necrosis was noted at the heparin-lock insertion site. DISCUSSION: Only one case of oxacillin-induced necrosis has been reported. The degree of damage and concentration of drug used were not specifically described. Concentration may play a role in the appearance or absence of tissue damage after an antibiotic extravasation and should be taken into consideration when evaluating a drug's tissue toxicity potential. CONCLUSIONS: The potential exists for oxacillin 50 mg/mL to cause tissue damage in humans if an extravasation occurs. This reaction may be avoided with use of a less-concentrated preparation, avoidance of infusion pump administration, and identification of high-risk patients.- - - - - - - - - - ranking = 1.1666666666667keywords = necrosis (Clic here for more details about this article) |
3/40. Two case reports of vinorelbine extravasation: management and review of the literature.Vinorelbine tartrate (Navelbine, Burroughs Wellcome Company, research Triangle Park, NC, USA) is a semisynthetic vinca alkaloid approved in many countries for the first-line treatment of patients with advanced non-small-cell lung cancer. It is also used in the treatment of advanced breast and ovarian cancers and lymphoma. Like other vinca alkaloids, Navelbine can cause skin necrosis as a consequence of inadvertent extravasation in surrounding tissues during intravenous administration. In such cases, early treatment is strongly advocated. There is no documented case of vinorelbine extravasation in the literature. The authors herein report two cases successfully treated with hyaluronidase injections plus saline flushout under local anesthesia.- - - - - - - - - - ranking = 0.16666666666667keywords = necrosis (Clic here for more details about this article) |
4/40. Hypotensive hemorrhagic necrosis in basal ganglia and brainstem.Hypotensive hemorrhagic necrosis of the basal ganglia and brainstem has only occasionally been described. Three such cases are reported. Cardiac arrest had occurred in all cases, and it took at least 1 hour to restore adequate circulation. The patients remained comatose for 2 days to 2 weeks until death. Persistent hypotension causing ischemia in the distribution of deep perforating arteries is considered to have been the key underlying mechanism. hemorrhage is thought to have been caused by extravasation of red blood cells through damaged blood vessels.- - - - - - - - - - ranking = 0.83333333333333keywords = necrosis (Clic here for more details about this article) |
5/40. Case report: total parenteral nutrition extravasation associated with spinal cord compression and necrosis.A preterm infant, whose course was complicated by sepsis, necrotizing enterocolitis with jejunal perforation, intraventricular hemorrhage and cerebellar hemorrhage, suffered permanent and total paralysis below the neck from extravasation of parenteral nutrition fluids through a femoral venous catheter. MRI imaging revealed extravasation of fluid into the paraspinus musculature with extension into the spinal canal. This fluid was identified as hyperalimentation and intralipid. Postmortem examination found evidence of necrosis of the spinal cord as well as perforation of the right iliac vein.- - - - - - - - - - ranking = 0.83333333333333keywords = necrosis (Clic here for more details about this article) |
6/40. Docetaxel extravasation.We report on an accidental extravasation of docetaxel given intravenously as chemotherapy in a cancer patient. The extravasate was immediately diluted subcutaneously with saline, in addition to which hypothermia (ice-packs) was implemented and topical dimethylsulfoxide (DMSO) was applied three times every 45 min. Corticosteroids and diclofenac were also administered. dermatitis developed immediately but had disappeared within 24 h. Notably, dermatopathological changes were absent on days 2-4, minimal on day 5, and increased thereafter. dermatitis developed as a late symptom, resulting in brown discoloration and skin hyperplasia. No plastic surgical intervention was necessary. We propose that isotonic saline, topical DMSO and local hypothermia may have restricted the inflammation and tissue necrosis induced by the extravasation of docetaxel. Repetitive topical application of DMSO beyond the day of extravasation had no additional benefit.- - - - - - - - - - ranking = 0.16666666666667keywords = necrosis (Clic here for more details about this article) |
7/40. phentolamine use in a neonate for the prevention of dermal necrosis caused by dopamine: a case report.skin ischemia, necrosis, and gangrene are uncommon but known complications of dopamine extravasation. In most cases, these complications are associated with the use of high-dosage dopamine infusion. Subcutaneous phentolamine has been used as a therapeutic agent for these complications. However, this is the report of the first neonatal case report in the English literature of prompt reversal of imminent dermal ischemia and necrosis associated with low-dose dopamine infusion using subcutaneous phentolamine.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
8/40. skin necrosis after extravasation of low-dose vasopressin administered for septic shock.OBJECTIVE: To describe a case of severe skin necrosis resulting from peripheral intravenous administration of low-dose vasopressin in a patient with catecholamine-resistant septic shock. DESIGN: Case report. SETTING: Medical intensive care unit at the University of chicago, chicago, IL. PATIENT: A 46-yr-old female with ventilator-dependent, proliferative-phase acute respiratory distress syndrome complicated by pseudomonas aeruginosa bacteremia and sepsis. MEASUREMENTS AND MAIN RESULTS: A patient recovering from acute respiratory distress syndrome developed septic shock from pseudomonas aeruginosa bacteremia while in the medical intensive care unit. Vasopressin (0.04 units/min) was administered through a peripheral venous catheter for hypotension unresponsive to exogenous catecholamines. The patient subsequently developed severe ischemic necrosis of the skin and soft tissue surrounding the catheter site. The vasopressin was stopped, and the skin lesion progressed to bullae formation with extensive superficial erosion. CONCLUSIONS: Peripheral administration of low-dose vasopressin for septic shock should be discouraged because of the risk of ischemic skin complications.- - - - - - - - - - ranking = 1keywords = necrosis (Clic here for more details about this article) |
9/40. Extravasation of paclitaxel into breast tissue from central catheter port.A 53-year-old woman with advanced-stage ovarian cancer experienced extravasation of paclitaxel into the breast tissue as a result of inappropriate needle insertion and/or dislodgement; it came from a central catheter port (CCP) that was found to be intact under radiological examination with contrast material. The breast became tender and oedematous with erythema, and local warming was observed within a few hours. The patient improved in the next few days during nonsteroidal anti-inflammatory medication and close observation, and the breast healed with thickened and darkened skin and central scarring in the 6th month of follow-up. To the best of our knowledge, extravasation into breast tissue is rare in the literature. Extravasation of vesicant drugs from CCP can cause tissue necrosis; it is therefore essential that ports be carefully assessed and used by experienced staff to lessen the likelihood of such an unpleasant complication.- - - - - - - - - - ranking = 0.16666666666667keywords = necrosis (Clic here for more details about this article) |
10/40. dexrazoxane-a promising antidote in the treatment of accidental extravasation of anthracyclines.Accidental extravasation of chemotherapy containing anthracycline often causes mutilating complications as a result of extensive tissue necrosis. Treatment therefore consists of extensive surgical debridement. We present the case of a 41-year-old woman with breast cancer who experienced extravasation of epirubicin. She was treated with an intravenous infusion of dexrazoxane for three successive days and recovered without surgical treatment and only slightly dysaesthesia in the surrounding tissue. Although infusion of dexrazoxane for this indication is still experimental we consider it a promising treatment for patients who have accidental extravasation of anthracyclines.- - - - - - - - - - ranking = 0.16666666666667keywords = necrosis (Clic here for more details about this article) |
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