Management of extravasation of oxaliplatin by mimicking its biotransformation.

Although oxaliplatin (Oxali) plays a key role in the treatment of many types of cancer and has been reported to be an irritant, there is no specific and effective method for its extravasation and failure in Oxali extravasation management results in the need for plastic surgery. In the body, Oxali bio-transforms upon dilution in chloride-containing buffer salts to its di-chloro derivative and loses an oxalate molecule. Consequently, the chloride ions exchange with water molecules in the intracellular environment to produce the di-aqua derivative, which is the most active biotransformation product of Oxali in terms of forming the DNA adducts. Thus, inhibiting transformation of di-chloro to di-aqua derivatives by accumulating chloride ions at the site of extravasation and saturating the Oxali molecule with these ions is a strategy that could help manage extravasation. Injecting normal saline at this site is a simple yet effective way to achieve this goal.

Treatment of anthracycline extravasations using dexrazoxane.

Extravasation of cytotoxic agents is a true medical emergency. Dexrazoxane is the only licensed drug for the treatment of anthracycline extravasations. Dexrazoxane proved to be effective and moderately well tolerated. However, alternative approaches for the management of anthracycline extravasations are available such as topical DMSO and cooling. There appears to be general agreement about dexrazoxane usefulness when extravasations involve large volumes of anthracycline and/or central venous access device. Nevertheless, the non-invasive combination of DMSO and cooling is the most commonly described therapy, particularly in small anthracycline extravasations. Further research is still needed to establish unequivocal situations where dexrazoxane must be initiated.

A avaliação da rede venosa pela enfermagem em mulheres com câncer ginecológico durante o tratamento quimioterápico / Venous network assessment by nursing in women with gynecological cancer during chemotherapy treatment / Evaluación de la red venosa por la enfermería en mujeres con cáncer ginecológico durante el tratamiento de quimioterapia

Estudo de abordagem exploratória e descritiva que teve como objetivos: avaliar a rede venosa das mulheres com câncer cérvico uterino, no início e ao final do tratamento quimioterápico; analisar a ocorrência de flebite provocada pelas drogas utilizadas nos protocolos de quimioterapia neoadjuvante e adjuvante e relacionar os tipos de veia com os dispositivos mais utilizados, tempo de permanência e intercorrências. Utilizou-se um instrumento de avaliação da rede venosa para os membros superiores. Foram incluídas 20 mulheres atendidas em um hospital de ensino do interior do Estado de São Paulo. A avaliação da rede venosa demonstrou poucas alterações, e a intercorrência mais frequente foi o hematoma (60%). Os resultados deste estudo apontam para aspectos da prática de enfermagem relacionados à administração de quimioterápicos e ressaltam a necessidade de elaborar e implantar protocolos para o cuidado.

This descriptive and exploratory study aimed to evaluate the venous network of women with cervical uterine cancer, at the beginning and at the end of the chemotherapy treatment; to analyze the occurrence of phlebitis caused by the drugs used in protocols of neoadjuvant and adjuvant chemotherapy and to relate the types of vein with the most used devices, length of stay and complications. An instrument was used to evaluate the venous network for upper limbs. Participants were twenty women who received care at a teaching hospital in the interior of the state of Sao Paulo. The evaluation of the venous network presented little changes and hematoma was the most frequent complication (60%). The results point out aspects of the nursing practice, related to the administration of chemotherapeutic agents, and highlight the need to develop and implement care protocols.

Este estudio exploratorio y descriptivo tuvo como objetivos evaluar la red venosa de las mujeres con cáncer de cuello uterino en el comienzo y el final del tratamiento quimioterápico, analizar la ocurrencia de flebitis causada por los fármacos utilizados en los protocolos de quimioterapia neo adyuvante y adyuvante, y relacionar los tipos de venas con los dispositivos más utilizados, tiempo de permanencia y complicaciones. Se utilizó un instrumento para evaluar la red venosa de los miembros superiores. Participaron 20 mujeres tratadas en un hospital de enseñanza en el interior del estado de São Paulo. La evaluación de la red venosa mostró pocas alteraciones y la complicación más frecuente fue el hematoma (60%). Los resultados del estudio apuntan aspectos de la práctica de enfermería relacionados a la administración de agentes quimioterápicos y señalan la necesidad de desarrollar e implementar protocolos de atención.

[Use of sterile petrolatum for extravasation injury in a premature infant]. / Tratamiento con vaselina estéril para lesión por extravasación en un prematuro.

The skin of premature infants is an ineffective barrier. The stratum corneum is thinner than that found in full-term infants. We report on a premature patient with extravasation injury from sodium bicarbonate. Daily treatment with sterile petrolatum resulted in restitutio ad integrum.