Atentar para os fatores de risco de cada indivíduo (veias filiformes e/ou frágeis, obesidade, múltiplas punções venosas prévias, presença de doenças de pele disseminadas (por exemplo, eczema ou psoríase), movimentação do paciente e nível de consciência (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1515 Matsui Y, Murayama R, Tanabe H, Oe M, Motoo Y, Wagatsuma T, et al. Evaluation of the predictive validity of thermography in identifying extravasation with intravenous chemotherapy infusions. J InfusNurs [Internet]. 2017 [cited 2018 Aug 25];40(6):367-74. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680995/. https://www.ncbi.nlm.nih.gov/pmc/article...
,1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2626 Dougherty L, Oakley C. Advanced practice in the management of extravasation: Lisa Dougherty and Catherine Oakley report how chemotherapy nurses in south London have been trained in the flush-out technique. Cancer Nursing Practice [Internet]. 2011 [cited 2018 Sep 28];10(5):16-22. Available from: http://cancernursingpractice.rcnpublishing.co.uk/index.asp
http://cancernursingpractice.rcnpublishi...
,2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
|
Aconselhar o paciente a relatar qualquer nível de dor, ardência, formigamento ou prurido, o que sugere infiltração perivenosa, ou seja, orientado para o reconhecimento do extravasamento (1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016.
17 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. -1818 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2929 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
30 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
|
Evitar punção em membros com perda de sensibilidade, local de manipulação cirúrgica e membros irradiados anteriormente (1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. -1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2626 Dougherty L, Oakley C. Advanced practice in the management of extravasation: Lisa Dougherty and Catherine Oakley report how chemotherapy nurses in south London have been trained in the flush-out technique. Cancer Nursing Practice [Internet]. 2011 [cited 2018 Sep 28];10(5):16-22. Available from: http://cancernursingpractice.rcnpublishing.co.uk/index.asp
http://cancernursingpractice.rcnpublishi...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
|
Evitar puncionar locais como pulso, dorso da mão e proximidades das articulações (1515 Matsui Y, Murayama R, Tanabe H, Oe M, Motoo Y, Wagatsuma T, et al. Evaluation of the predictive validity of thermography in identifying extravasation with intravenous chemotherapy infusions. J InfusNurs [Internet]. 2017 [cited 2018 Aug 25];40(6):367-74. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680995/. https://www.ncbi.nlm.nih.gov/pmc/article...
16 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. -1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
29 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
30 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Evitar a utilização de acessos periféricos canalizados há mais de 24 horas, preferindo punção no momento (1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. -1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2929 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
30 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Evitar a utilização de dispositivos rígidos para a administração de QT vesicante (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Utilizar sempre como material ideal de um cateter venoso periférico para administração de QT: quimicamente inerte, não trombogênico, flexível, radiopaco e transparente (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Fixar o acesso venoso com meios que deixem o local da punção visível (1515 Matsui Y, Murayama R, Tanabe H, Oe M, Motoo Y, Wagatsuma T, et al. Evaluation of the predictive validity of thermography in identifying extravasation with intravenous chemotherapy infusions. J InfusNurs [Internet]. 2017 [cited 2018 Aug 25];40(6):367-74. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680995/. https://www.ncbi.nlm.nih.gov/pmc/article...
,2020 Harrold K, Gould D, Drey N. The efficacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report. Eur J Cancer Care [Internet]. 2013 [cited 2018 Sep 28];22(2):169-78. Available from:https://doi.org/10.1111/ecc.12023
https://doi.org/10.1111/ecc.12023...
)
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Avaliar constantemente para risco de extravasamento venoso periférico (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1515 Matsui Y, Murayama R, Tanabe H, Oe M, Motoo Y, Wagatsuma T, et al. Evaluation of the predictive validity of thermography in identifying extravasation with intravenous chemotherapy infusions. J InfusNurs [Internet]. 2017 [cited 2018 Aug 25];40(6):367-74. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680995/. https://www.ncbi.nlm.nih.gov/pmc/article...
16 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016.
17 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015.
18 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
-1919 Muthuramalingam S, Gale J, Bradbury J. Dexrazoxane efficacy for anthracycline extravasation: use in UK clinical practice. Int J Clin Pract [Internet]. 2013 [cited 2018 Sep 28];67(3):244-9. Available from: https://doi.org/10.1111/ijcp.12103
https://doi.org/10.1111/ijcp.12103...
,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2727 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
28 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
29 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
30 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Verificar o fluxo sanguíneo, após punção e, em seguida, lavar com 10 ml de solução salina normal e verificar se há sinais de extravasamento (2929 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
-3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
). |
Lavar com 10 a 20 ml de solução salina entre diferentes infusões de drogas antineoplásicas (3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Verificar o retorno de sangue antes que a QT seja administrada e, regularmente, durante a infusão em bolus
(3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Administrar soluções fisiológicas concomitantemente à infusão de QT vesicante e/ou irritante (1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. ,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Monitorizar o acesso puncionado tanto para avaliação da permeabilidade deste como também para a rápida visualização de possíveis reações oriundas de lesões vasculares ou extravasamento (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1515 Matsui Y, Murayama R, Tanabe H, Oe M, Motoo Y, Wagatsuma T, et al. Evaluation of the predictive validity of thermography in identifying extravasation with intravenous chemotherapy infusions. J InfusNurs [Internet]. 2017 [cited 2018 Aug 25];40(6):367-74. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680995/. https://www.ncbi.nlm.nih.gov/pmc/article...
16 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. -1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Contraindicar o uso de bombas de infusão para QT em bolus
(1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Treinar a equipe de enfermagem e implementar protocolos de prevenção de extravasamento de QT são cruciais (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. -1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
29 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
-3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Recomendar o uso de acesso venoso central para administração de drogas vesicantes ou irritantes (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016. -1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Aconselhar os pacientes a obter acesso venoso central sempre que indicado e fornecer o consentimento informado sobre os riscos e benefícios de tal acesso (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,2929 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
-3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Condutas frente ao extravasamento de agentes antineoplásicos em adultos
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Usar a incidência de extravasamento como um indicador de qualidade (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1818 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Treinar a equipe de enfermagem e implementar protocolos de condutas nos extravasamentos de QT (2020 Harrold K, Gould D, Drey N. The efficacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report. Eur J Cancer Care [Internet]. 2013 [cited 2018 Sep 28];22(2):169-78. Available from:https://doi.org/10.1111/ecc.12023
https://doi.org/10.1111/ecc.12023...
,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2626 Dougherty L, Oakley C. Advanced practice in the management of extravasation: Lisa Dougherty and Catherine Oakley report how chemotherapy nurses in south London have been trained in the flush-out technique. Cancer Nursing Practice [Internet]. 2011 [cited 2018 Sep 28];10(5):16-22. Available from: http://cancernursingpractice.rcnpublishing.co.uk/index.asp
http://cancernursingpractice.rcnpublishi...
27 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
-2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Lembrar que, caso ocorra um extravasamento, o grau de dano depende do tipo de droga, da concentração do fármaco, da localização do extravasamento e do tempo que um medicamento desenvolve seu potencial de dano (2626 Dougherty L, Oakley C. Advanced practice in the management of extravasation: Lisa Dougherty and Catherine Oakley report how chemotherapy nurses in south London have been trained in the flush-out technique. Cancer Nursing Practice [Internet]. 2011 [cited 2018 Sep 28];10(5):16-22. Available from: http://cancernursingpractice.rcnpublishing.co.uk/index.asp
http://cancernursingpractice.rcnpublishi...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Parar a infusão de QT é a primeira medida quando ocorre o extravasamento ou sua suspeita (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2727 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Atentar para: em caso de um extravasamento suspeito, tratá-lo como um evento real (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Realizar a aspiração da droga, a elevação do membro e a aplicação de compressa térmica (frio ou calor) (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2020 Harrold K, Gould D, Drey N. The efficacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report. Eur J Cancer Care [Internet]. 2013 [cited 2018 Sep 28];22(2):169-78. Available from:https://doi.org/10.1111/ecc.12023
https://doi.org/10.1111/ecc.12023...
,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,2727 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Demarcar e fotografar a área com extravasamento de QT (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2424 Tsavaris NB, Komitsopoulou P, Karagiaouris P, Loukatou P, Tzannou I, Mylonakis N, et al. Prevention of tissue necrosis due to accidental extravasation of cytostatic drugs by a conservative approach. Cancer Chemoth Pharm [Internet]. 1992 [cited 2018 Sep 28];30(4):330-3. Available from: https://link-springer-com.ez18.periodicos.capes.gov.br/content/pdf/10.1007%2FBF00686305.pdf
https://link-springer-com.ez18.periodico...
-2525 Olver IN, Aisner J, Hament A, Buchanan L, Bishop JF, Kaplan RS. A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation. J Clin Oncol[Internet].1988[cited 2018 20 Dec];6(11):1732-5. Available from:https://doi.org/10.1200/JCO.1988.6.11.1732
https://doi.org/10.1200/JCO.1988.6.11.17...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Aplicar compressa durante 20 minutos, quatro vezes por dia durante um ou dois dias somente para QT classificadas como alcaloides da vinca (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
,3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Aplicar compressas frias nos extravasamentos por antraciclinas, antibióticos tumorais e agentes alquilantes. Somente na oxaliplatina é aplicado calor (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2222 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
-2323 Adami NP, de Gutiérrez MG, da Fonseca SM, de Almeida EP. Risk management of extravasation of cytostatic drugs at the adult chemotherapy outpatient clinic of a University Hospital. J Clin Nurs [Internet]. 2005 [cited 2018 Sep 28];14(7):876-82. Available from: https://doi.org/10.1111/j.1365-2702.2005.01124.x
https://doi.org/10.1111/j.1365-2702.2005...
)
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Acompanhar o extravasamento de QT (enfermeiro e provedor de pacientes), sendo ele extravasamento real ou suspeito (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2424 Tsavaris NB, Komitsopoulou P, Karagiaouris P, Loukatou P, Tzannou I, Mylonakis N, et al. Prevention of tissue necrosis due to accidental extravasation of cytostatic drugs by a conservative approach. Cancer Chemoth Pharm [Internet]. 1992 [cited 2018 Sep 28];30(4):330-3. Available from: https://link-springer-com.ez18.periodicos.capes.gov.br/content/pdf/10.1007%2FBF00686305.pdf
https://link-springer-com.ez18.periodico...
25 Olver IN, Aisner J, Hament A, Buchanan L, Bishop JF, Kaplan RS. A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation. J Clin Oncol[Internet].1988[cited 2018 20 Dec];6(11):1732-5. Available from:https://doi.org/10.1200/JCO.1988.6.11.1732
https://doi.org/10.1200/JCO.1988.6.11.17...
26 Dougherty L, Oakley C. Advanced practice in the management of extravasation: Lisa Dougherty and Catherine Oakley report how chemotherapy nurses in south London have been trained in the flush-out technique. Cancer Nursing Practice [Internet]. 2011 [cited 2018 Sep 28];10(5):16-22. Available from: http://cancernursingpractice.rcnpublishing.co.uk/index.asp
http://cancernursingpractice.rcnpublishi...
27 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
-2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Acompanhar o extravasamento por telefone ou pessoalmente. No dia 1 após o evento e, no mínimo, semanalmente (ou com mais frequência, conforme necessário). O acompanhamento deve continuar por um período de três a seis semanas, ou até a resolução completa do extravasamento (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Iniciar o mais cedo possível (até 6 horas) o dexrazoxane (Savene®), único antídoto licenciado para o tratamento de extravasamento deantraciclina (1919 Muthuramalingam S, Gale J, Bradbury J. Dexrazoxane efficacy for anthracycline extravasation: use in UK clinical practice. Int J Clin Pract [Internet]. 2013 [cited 2018 Sep 28];67(3):244-9. Available from: https://doi.org/10.1111/ijcp.12103
https://doi.org/10.1111/ijcp.12103...
20 Harrold K, Gould D, Drey N. The efficacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report. Eur J Cancer Care [Internet]. 2013 [cited 2018 Sep 28];22(2):169-78. Available from:https://doi.org/10.1111/ecc.12023
https://doi.org/10.1111/ecc.12023...
-2121 Drake D. BET3: Emergency management of anthracycline extravasation. Emerg Med J [Internet]. 2012 [cited 2018 Sep 28]; 29(9):777-9. Available from:http://dx.doi.org/10.1136/emermed-2012-201686.4
http://dx.doi.org/10.1136/emermed-2012-2...
,2727 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
); administrar por via intravenosa em uma veia em uma área longe do local do extravasamento, a uma dose de 1000 mg/m2 dia e de dois a 500 mg/m2 no dia três (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015.
18 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
-1919 Muthuramalingam S, Gale J, Bradbury J. Dexrazoxane efficacy for anthracycline extravasation: use in UK clinical practice. Int J Clin Pract [Internet]. 2013 [cited 2018 Sep 28];67(3):244-9. Available from: https://doi.org/10.1111/ijcp.12103
https://doi.org/10.1111/ijcp.12103...
,2121 Drake D. BET3: Emergency management of anthracycline extravasation. Emerg Med J [Internet]. 2012 [cited 2018 Sep 28]; 29(9):777-9. Available from:http://dx.doi.org/10.1136/emermed-2012-201686.4
http://dx.doi.org/10.1136/emermed-2012-2...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Iniciar o mais cedo possível DMSO tópico (99%), de preferência nos primeiros 10 minutos, em caso de extravasamento de mitomicina C. Deve ser aplicado a cada 8 horas durante 7 dias (1818 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
,2727 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
-2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Usar tiossulfato de sódio 0,17 M (uma solução de tiossulfato de sódio 4 ml de 10% e 6 ml de água estéril para injeção) em injeção subcutânea imediatamente em caso de extravasamento de Mecloretamina. Injeção subcutânea de 2 ml de solução feita a partir de 4 ml de tiossulfato de sódio + 6 ml de água estéril (2424 Tsavaris NB, Komitsopoulou P, Karagiaouris P, Loukatou P, Tzannou I, Mylonakis N, et al. Prevention of tissue necrosis due to accidental extravasation of cytostatic drugs by a conservative approach. Cancer Chemoth Pharm [Internet]. 1992 [cited 2018 Sep 28];30(4):330-3. Available from: https://link-springer-com.ez18.periodicos.capes.gov.br/content/pdf/10.1007%2FBF00686305.pdf
https://link-springer-com.ez18.periodico...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Administrar hialuronidase em injeção subcutânea (150-900 UI ao redor da área de extravasamento) em caso de extravasamento de alcaloides da vinca (2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
), após, aplicação de calor seco durante um período de sete dias (três vezes ao dia) (2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Administrar hialuronidase em injeção subcutânea150-900 UI ao redor da área de extravasamento de taxanos (3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
), sem aplicação de calor após o extravasamento de paclitaxel (2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
)
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Atentar para não usar corticosteroides subcutâneo (2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
) e tópico em extravasamentos de QT (1717 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ,2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
)
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Avisar ao médico do paciente e consultar um cirurgião plástico dentro de 24 horas após detecção de extravasamento de agente antineoplásico vesicante (2828 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
,3030 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Documentar fotograficamente (autorizada por escrito pelo paciente) e registrar em prontuário a data, horário, nome do medicamento extravasado, sinais e sintomas, descrição do acesso venoso, local do extravasamento, além da evolução do caso de extravasamento de QT (99 Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al. Chemotherapy Extravasation: establishing a national benchmark for incidence among Cancer Centers. Clin J Oncol Nurs [Internet]. 2017 [cited 2018 Aug 05]; 21(4):438-45. Available from: http://dx.doi-org.ez18.periodicos.capes.gov.br/10.1188/17.CJON.438-445
http://dx.doi-org.ez18.periodicos.capes....
,1616 Custódio, CS. Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal [Dissertação]. Brasília (DF): Universidade de Brasília; 2016.
17 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015.
18 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
19 Muthuramalingam S, Gale J, Bradbury J. Dexrazoxane efficacy for anthracycline extravasation: use in UK clinical practice. Int J Clin Pract [Internet]. 2013 [cited 2018 Sep 28];67(3):244-9. Available from: https://doi.org/10.1111/ijcp.12103
https://doi.org/10.1111/ijcp.12103...
20 Harrold K, Gould D, Drey N. The efficacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report. Eur J Cancer Care [Internet]. 2013 [cited 2018 Sep 28];22(2):169-78. Available from:https://doi.org/10.1111/ecc.12023
https://doi.org/10.1111/ecc.12023...
21 Drake D. BET3: Emergency management of anthracycline extravasation. Emerg Med J [Internet]. 2012 [cited 2018 Sep 28]; 29(9):777-9. Available from:http://dx.doi.org/10.1136/emermed-2012-201686.4
http://dx.doi.org/10.1136/emermed-2012-2...
22 Schneider F, Pedrolo E. Extravasation of antineoplastic drugs: assessment of the nursing team knowledge. Rev Min Enferm [Internet]. 2011 [cited 2018 July 25];15(4):522-9. Available from: http://www.reme.org.br/artigo/detalhes/66. http://www.reme.org.br/artigo/detalhes/6...
23 Adami NP, de Gutiérrez MG, da Fonseca SM, de Almeida EP. Risk management of extravasation of cytostatic drugs at the adult chemotherapy outpatient clinic of a University Hospital. J Clin Nurs [Internet]. 2005 [cited 2018 Sep 28];14(7):876-82. Available from: https://doi.org/10.1111/j.1365-2702.2005.01124.x
https://doi.org/10.1111/j.1365-2702.2005...
24 Tsavaris NB, Komitsopoulou P, Karagiaouris P, Loukatou P, Tzannou I, Mylonakis N, et al. Prevention of tissue necrosis due to accidental extravasation of cytostatic drugs by a conservative approach. Cancer Chemoth Pharm [Internet]. 1992 [cited 2018 Sep 28];30(4):330-3. Available from: https://link-springer-com.ez18.periodicos.capes.gov.br/content/pdf/10.1007%2FBF00686305.pdf
https://link-springer-com.ez18.periodico...
25 Olver IN, Aisner J, Hament A, Buchanan L, Bishop JF, Kaplan RS. A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation. J Clin Oncol[Internet].1988[cited 2018 20 Dec];6(11):1732-5. Available from:https://doi.org/10.1200/JCO.1988.6.11.1732
https://doi.org/10.1200/JCO.1988.6.11.17...
26 Dougherty L, Oakley C. Advanced practice in the management of extravasation: Lisa Dougherty and Catherine Oakley report how chemotherapy nurses in south London have been trained in the flush-out technique. Cancer Nursing Practice [Internet]. 2011 [cited 2018 Sep 28];10(5):16-22. Available from: http://cancernursingpractice.rcnpublishing.co.uk/index.asp
http://cancernursingpractice.rcnpublishi...
27 Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg [Internet]. 2017 [cited 2018 Sep 28];79(5):450-7. Available from: https://doi.org/10.1097/SAP.0000000000001248
https://doi.org/10.1097/SAP.000000000000...
28 Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al. Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol. Support Care Cancer [Internet]. 2015 [cited 2018 Sep 28];23(6):1741-8. Available from: https://link.springer.com/content/pdf/10.1007%2Fs00520-014-2535-2.pdf
https://link.springer.com/content/pdf/10...
29 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
30 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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Manter um kit de emergência para extravasamento (contendo, no mínimo: luvas de procedimentos, avental de baixa permeabilidade, compressas absorventes, proteção respiratória e ocular, sabão, recipiente identificado para recolhimento dos resíduos) sempre disponível nos locais onde são administrados agentes antineoplásicos (1818 Harrold K, Gould D, Drey N. The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice. Eur J Cancer Care [Internet]. 2015 [cited 2018 Sep 28];24(6):771-800. Available from: https://doi.org/10.1111/ecc.12363
https://doi.org/10.1111/ecc.12363...
,2929 de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al. Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment. Onkologie [Internet]. 2013 [cited 2018 Sep 28];36(3):127-35. Available from: https://doi.org/10.1159/000348524
https://doi.org/10.1159/000348524...
30 Pérez Fidalgo JA, García Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines Working Group. Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines. Ann Oncol [Internet]. 2012 [cited 2018 Sep 28];23(Suppl 7):vii167-vii173. Available from: https://doi.org/10.1093/annonc/mds294
https://doi.org/10.1093/annonc/mds294...
-3131 Wengström Y, Margulies A, European Oncology Nursing Society Task Force. European Oncology Nursing Society extravasation guidelines. Eur J Oncol Nurs [Internet]. 2008 [cited 2018 Sep 28];12(4):357-61. Available from: https://doi.org/10.1016/j.ejon.2008.07.003
https://doi.org/10.1016/j.ejon.2008.07.0...
)
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