Evaluation of Characteristics Associated With Peripheral Parenteral Nutrition Extravasation: A Descriptive Analysis in a Japanese University Hospital.

Abstract

Objective: This study aimed to describe the characteristics of patients who experienced peripheral parenteral nutrition (PPN) extravasation and to analyze the clinical contexts at the time of PPN extravasation.

Methods: This descriptive study included patients who experienced PPN extravasation between 2018 and 2023 at a university hospital in Japan and was based on extravasation reports registered in the electronic medical record system by nurses.

Results: In total, 302 PPN extravasation cases were reported in 235 patients. The most common age group was the 70s (33.89%), with neoplasms as the predominant diagnosis (42.68%). Median (interquartile range) albumin and D-dimer levels were 2.9 (2.5-3.3) g/dL and 4.57 (1.69-8.96) µg/mL, respectively. The most common symptom of PPN extravasation was swelling (75.50%), followed by pain (50.00%). PPN extravasation was most frequently detected between 10:00 and 11:00 AM, and detections were made primarily through nurse observation (54.87%).

Conclusions: Aging, neoplasms (especially hematological malignancy), malnutrition, and blood coagulation abnormalities were common characteristics of patients with PPN extravasation. Nurses should be careful about PPN extravasation even at midnight or in the early hours of the morning because of the relatively poor subjective symptoms, such as pain and discomfort, caused by PPN extravasation.