Vesiculobullous Eruption due to Extravasation of Intravenous Fluid: A Brief Review

Abstract

Abstract Introduction: Intravenous (IV) cannulation for peripheral or central venous access is a commonly done procedure in hospitals. Extravasation of IV fluids is one of the iatrogenic complications encountered. Extravasation injury may range from mild benign injury most of the time to edema, bullous lesion, severe tissue necrosis, and compartment syndrome. Methods: “Extravasation” and “Intravenous fluid” are searched in PubMed, PubMed Central, and Medline with articles published in the past 5 years. Few off topics such as “blood extravasation,” “extravasation injury to brain,” animal studies, and “extravasation of anticancer drugs” are excluded from the study. Twenty-one articles including review, meta-analysis, and case reports are selected for review. Results: While much of the focus is on peripheral venous access, for central venous catheters, extravasation is less frequent but potentially more dangerous because the anatomical structures escape attention. Along with mechanical factors such as volume of fluid administered and wrong placement of cannula, underlying diseases such as cancer, diabetes, and inherent property of IV fluid or infusion may be responsible for extravasation injury. Pain, paresthesia, pallor, and pulse to be examined and monitored while suspecting an extravasation injury. Ultrasonography and color Doppler might help to identify early lesions, but a high degree of clinical suspicion is necessary for unconscious patients in the intensive care unit. A detailed discussion on this topic is followed in this article. Conclusion: Patients should have their infusion site routinely inspected. The prevention of potentially fatal consequences depends on careful adherence to recommended procedures and prompt recognition of signs and symptoms.