Prevenção e conduta frente ao Extravasamento de agentes antineoplásicos: <i>scoping review</i>

Melo, João Marcos Alves; Oliveira, Patrícia Peres de; Souza, Raíssa Silva; Fonseca, Deborah Franscielle da; Gontijo, Thaís Fonseca; Rodrigues, Andrea Bezerra

Acessibilidade / Reportar erro

Brasil

Revista Brasileira de Enfermagem

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVISÃO • Rev. Bras. Enferm. 73 (4) • 2020 • https://doi.org/10.1590/0034-7167-2019-0008 copiar

Prevenção e conduta frente ao Extravasamento de agentes antineoplásicos: scoping review

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivos:

identificar e sintetizar as evidências científicas sobre prevenção e conduta do extravasamento de agentes antineoplásicos em pacientes adultos realizado por enfermeiros.

Métodos:

scoping review, conforme Joanna Briggs Institute e o PRISMA-ScR. Realizou-se pesquisa em cinco bases de dados eletrônicas, na Biblioteca Cochrane e em oito catálogos de teses e dissertações. A coleta de dados ocorreu de abril a julho de 2018, sem limite temporal. Os dados extraídos foram analisados e sintetizados de forma narrativa.

Resultados:

foram recuperados um total de 3.110 registros e mantidos 18 estudos para a revisão. A maioria das publicações (66,6%) tinha abordagem qualitativa e apresentaram as duas vertentes, ou seja, prevenção e conduta frente ao extravasamento de quimioterapia em pacientes adultos.

Conclusões:

é primordial a implementação de protocolos baseados na evidência científica sobre prevenção e conduta diante do extravasamento de antineoplásicos a fim de fornecer segurança ao paciente e respaldo à equipe de enfermagem.

Descritores:
Quimioterapia Combinada; Antineoplásicos; Cuidados de Enfermagem; Extravasamento de Materiais Terapêuticos e Diagnósticos; Oncologia

Autor (res)	Ano	Tipo / Título	Periódico ou instituição	Objetivo(s)
Jackson-Rose J, Del Monte J, Groman A, Dial LS, Atwell L, Graham J, et al ⁽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.... ⁾	2017	Artigo / Chemotherapy extravasation: establishing a national benchmark for incidence among cancer centers	Clinical Journal of Oncology Nursing	- Avaliar o extravasamento de QT vesicante em pacientes adultos com câncer (739.812 doses de infusões de QT vesicante e irritante foram incluídas na avaliação de 11 serviços oncológicos); - Apresentar a incidência de extravasamento de QT vesicantes, irritantes e irritantes com potencial vesicante.
Matsui Y, Murayama R, TanabeH, Oe M, Motoo Y, Wagatsuma T, et al ⁽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... ⁾	2017	Artigo / Evaluation of the predictive validity of thermography in identifying extravasation with intravenous chemotherapy infusions	Journal of Infusion Nursing	- Avaliar a validade preditiva da termografia para identificar o extravasamento durante a terapia antineoplásica endovenosa.
Custódio CS ⁽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. ⁾	2016	Dissertação / Injurias vasculares relacionadas a infusão periférica de quimioterapia em mulheres com câncer de mama: estudo longitudinal	Repositório da UnB	- Avaliar as alterações de veias periféricas utilizadas para infusão de quimioterapia em pacientes com câncer de mama ao longo do tempo do tratamento e descrever cuidados e orientações na escolha dos acessos venosos para infusão QT.
Freitas KABS ⁽¹⁷17 Freitas KABS. Estratégias para a administração segura de antineoplásicos [Dissertação]. Universidade Estadual Paulista, Faculdade de Medicina de Botucatu, Botucatu (SP); 2015. ⁾	2015	Dissertação / Estratégias para administração segura de antineoplásicos	Repositório Instucional da UNESP	- Traçar o perfil e o conhecimento em QT dos enfermeiros de unidades de internação de um Hospital Universitário e desenvolver estratégias para administração segura dos antineoplásicos.
Harrold K, Gould D, Drey N ⁽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... ⁾	2015	Artigo / The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice	European Journal of Oncology Nursing	-Analisar criticamente a qualidade das evidências que sustenta a prática contemporânea no manejo do extravasamento QT e verificar se a experiência do paciente é levada em conta em relação ao manejo do extravasamento QT.
Muthuramalingam S, Gale J, Bradbury J ⁽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... ⁾	2013	Artigo / Dexrazoxane efficacy for anthracycline extravasation: use in UK clinical practice	International Journal of Clinical Practice	- Apresentar a revisão de casos (102) publicados no Reino Unido sobre a eficácia do Dexrazoxane para o tratamento de extravasamento de antraciclina.
Harrold K, Gould D, Drey N ⁽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... ⁾	2013	Artigo / The efﬁcacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report	European Journal of Cancer Care	- Apresentar os resultados de uma série de casos históricos de extravasamentos de QT administrados por lavagem com solução salina e avaliar a eficácia do procedimento com base no desfecho do paciente.
Drake D ⁽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... ⁾	2012	Artigo / Emergency management of anthracycline extravasation	Emergency Medicine Journal	- Estabelecer que o dexrazoxano intravenoso reduz o risco de necrose tecidual após extração do agente quimioterápico antraciclina.
Schneider, F; Pedrolo, E. ⁽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... ⁾	2011	Artigo / Extravasamento de drogas antineoplásicas: avaliação do conhecimento da equipe de enfermagem	Revista Mineira de Enfermagem	- Apontar a importância de um aperfeiçoamento em serviço e da elaboração de uma diretriz clínica, a fim de que os profissionais identifiquem os pacientes com maior risco de extravasamento de QT e promovam ações de prevenção e de minimização de danos.
Adami NP, de Gutiérrez MG, da Fonseca SM, de Almeida EP ⁽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... ⁾	2005	Artigo / Risk management of extravasation of cytostatic drugs at the adult chemotherapy outpatient clinic of a University Hospital	Journal of Clinical Nursing	- Verificar a incidência de extravasamento de drogas antineoplásicas em pacientes atendidos ambulatorialmente em um hospital universitário por cinco anos e avaliar a qualidade do cuidado prestado pela equipe de enfermagem.
Tsavaris NB, Komitsopoulou P, Karagiaouris P, Loukatou P, Tzannou I, Mylonakis N, et al ⁽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... ⁾	1992	Artigo / Prevention of tissue necrosis due to accidental extravasation of cytostatic drugs by a conservative approach	Cancer Chemotherapy and Pharmacy.	- Avaliar comparativamente a eficácia de uma abordagem conservadora ao tratamento utilizando dois esquemas terapêuticos (com ou sem tiossulfato de sódio).
Olver IN, Aisner J, Hament A, Buchanan L, Bishop JF, Kaplan RS ⁽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... ⁾	1988	Artigo / A prospective study of topical dimethyl sulfoxide for treating anthracycline extravasation	Journal of Clinical Oncology	- Apresentar o tratamento de extravasamento de antraciclinas com 99% de dimetilsulfóxido tópico (DMSO) por um período de três meses com exames e fotografias regulares.

Autor(es)	Ano	Tipo / Título	Periódico ou instituição	Objetivo(s)
Dougherty L, Oakley C ⁽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... ⁾	2011	Artigo / Advanced practice in the management of extravasation	Cancer Nursing Practice	- Descrever o treinamento para enfermeiras na técnica de "flush-out" com o objetivo de oferecer intervenções mais oportunas e menos inconvenientes para os pacientes.

Autor (res)	Ano	Tipo /Título	Periódico ou instituição	Objetivo(s)
Onesti MG, Carella S, Fioramonti P, Scuderi N ⁽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... ⁾	2017	Artigo / Chemotherapy Extravasation Management: 21-Year Experience	Annals of Plastic Surgery	- Explorar a prevenção e tratamento de lesões extravasamento, propondo um protocolo terapêutico padrão, juntamente com uma revisão da literatura.
Pluschnig U, Haslik W, Bayer G, Soleiman A, Bartsch R, Lamm W, et al ⁽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... ⁾	2015	Artigo / Outcome of chemotherapy extravasation in a large patient series using a standardised management protocol	Support Care Cancer	- Observar o extravasamento de agentes antineoplásicos de 169 pacientes e avaliar a eficácia de seu manejo interdisciplinar em um único cenário de pesquisa.
de Wit M, Ortner P, Lipp HP, Sehouli J, Untch M, Ruhnke M, et al ⁽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... ⁾	2013	Artigo / Management of cytotoxic extravasation - ASORS expert opinion for diagnosis, prevention and treatment	Onkologie	- Revisar e discutir a prática no diagnóstico e manejo do extravasamento de QT.
Pérez Fidalgo JA, García Fabregat L, Cervantes A, et al ⁽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... ⁾	2012	Artigo / Management of chemotherapy extravasation: ESMO-EONS Clinical Practice Guidelines	European Journal of Oncology Nursing	- Apresentar as Diretrizes da European Society for Medical Oncology publicada em cooperação com a European Oncology Nursing Society (EONS).
Wengström Y, Margulies A, European Oncology Nursing Society Task Force ⁽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... ⁾	2008	Artigo / European Oncology Nursing Society extravasation guidelines	European Journal of Oncology Nursing	- Apresentar as Diretrizes para prevenção, detecção e gestão de extravasamento da European Oncology Nursing Society.

Medidas de prevenção do extravasamento de agentes antineoplásicos em adultos
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
Condutas frente ao extravasamento de agentes antineoplásicos em adultos
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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... ⁾
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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[1] Autor Correspondente: Patrícia Peres de Oliveira. E-mail: pperesoliveira@ufsj.edu.br