The final thing I want to talk to you about is something that is really kind of ordinary, that is intravenous complications. I think it is important to have the correct terminology.
- IV infiltration is leakage of a non-vesicant fluid from a vein
- extravasation is leakage of fluid or medication which is toxic to the tissue
The effects of these complications are mediated by:
- osmolality of the agent
- duration of contact
- pH
- mechanical pressure
- chemical irritation
- TPN
- NaHCO3
- calcium
- magnesium
- aminophylline
- pressors
- antibiotics
- blood products
- contrast media
This involves skin, subcutaneous tissue and, in small babies, even muscle. It has been reported to occur in 10% of NICU admissions, a surprisingly high figure. The morbidity is significant with one third of the babies having this problem requiring care. 50% are reported to occur in association with TPN.
The major causative agents are shown in the table at the right.