Extravasation (Paravasation) of Chemotherapy Drugs - Recommendations for Standard Care in the Czech Republic based on Consolations between Representatives of the Supportive Care Group of the Czech Society for Oncology, Oncology Section of the Czech Nurses Association, and the Society for Ports and Permanent Catheters.

BACKGROUND: Extravasation (paravasation) of chemotherapy drugs is a very significant complication in the treatment of cancer patients. Preventive and therapeutic interventions reduce the risk of this complication or the extent of its consequences. A working group of authors from expert groups prepared recommendations for standard care. PURPOSE: To prepare a basic summary of recommended interventions for daily practice, based on knowledge from long-term, proven, evidence-based practice or on consensus opinions of representatives of expert groups. RESULTS: Preventive measures are essential and include early consideration of long-term venous access device indications, choice of injection site, venous line control before each chemotherapy drug application, and patient education. Interventions in cases of extravasation mainly involve the application of antidotes (dimethylsulfoxide, hyaluronidase, and dexrazoxane) and the application of dry cold or heat, depending on the type of cytostatic drug. Corticosteroids injected subcutaneously, moist heat or cooling, and compression, are not recommended. CONCLUSION: The recommended procedures will contribute to reducing the risk and consequences of extravasation. The range of recommended interventions can be expanded depending on individual clinical workplace policy and needs. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 28. 9. 2019 Accepted: 13. 10. 2019.

[Implantations of venous ports--the latest advances]. / Implantace venózních portu - vývoj v posledních letech.

A continuously growing spectrum of cytostatic preparations used to treat oncological patients, as well as a growing spectrum of indications to treat patients with disseminated or locally advanced findings even in the elderly patients, brings on a subject of long-term venous portae problems to solve. The venous port is a smart solution of this problem. The method minimalizes risks resulting from long-term canylations of the central venous system and, primarily, substantially improves comfort of patients. This argument takes in consideration not only periods between chemotherapy applications, but also administration of the cytostatic preparation itself. The following article summarizes long-term experience with port implantations in the MOU. It points out increasing rates of patients with implanted ports and highlights frequency rates of observed complications connected with both the port implantation and the port use.