Lipid extravasation

[Rahmi]

Do you have experience on lipid extravasation in preterms? Emergency interventions? Prognosis?

[Stefan Johansson]

We connect both electrolyte/aminoacids/glucose and lipids to the same line.
If the we have extravasation of the TPN we take the infusion and canula away, but we do no emergency interventions besides that.

I come to think of two preterms with skin necrosis after TPN extravasation; one necrosis was located on the volar side of the hand and this child finally had surgery to cover the skin necrosis. The other child had a smaller necrosis on the foot which resolved without specific treatment.

Would be interested to hear more experience about this issue!

[jesreinholdt]

Extravasation of TPN is a problem in our unit. We try to use central lines (longlines) but sometimes it is not possible to have a central line. When we experience extravasated lipids we take out the i.v. line and try to press out as much of the lipids that is possible. Necrosis is a problem and sometimes we have to use skin transplants because of necrosis, but it is only few infants.


Jes Reinholdt
Rigshospitalet
Copenhagen

[bittybabygrower]

We inject saline in 0.1ml increments around the infiltrate to dilute the infusant. We have had good success with this. We have also used Wydase in the past.