• Oncology nursing forum · May 1995

    Case Reports

    Chemotherapy extravasation: a consequence of fibrin sheath formation around venous access devices.

    • D J Mayo and D C Pearson.
    • Critical Care/Heart, Lung and Blood and Cancer Nursing Service, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD, USA.
    • Oncol Nurs Forum. 1995 May 1; 22 (4): 675-80.

    Purpose/ObjectivesTo describe, using two case studies, chemotherapy drug extravasation as a consequence of fibrin sheath formation.Data SourcesJournal articles, textbooks, medical records, and personal experiences.Data SynthesisFibrin sheath formation around venous access devices (VADs) frequently leads to persistent withdrawal occlusion (PWO). While PWO often is easily managed with small doses of thrombolytic therapy (e.g., urokinase), it may result in a more serious complication, such as chemotherapy extravasation.ConclusionsChemotherapy should not be administered through a VAD unless a free-flowing blood return can be demonstrated.Implications For Nursing PracticeCareful nursing assessment of all VADs is important to identify complications such as fibrin sheath formation. To rule out fibrin sheath formation, nurses must obtain catheter dye studies when fibrinolytic therapy fails to restore catheter function.

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