Management of Infiltrated IV Line Running Lipids
For an infiltrated IV line infusing lipids, immediately discontinue the infusion, elevate the affected limb, and apply warm compresses to the area to promote absorption and reduce tissue damage.
Immediate Actions
- Immediately stop the lipid infusion when infiltration is detected 1
- Remove the IV catheter from the infiltrated site 2, 3
- Elevate the affected extremity to reduce swelling and promote absorption 3
- Apply warm compresses to the area to improve blood circulation and facilitate absorption of the infiltrated lipids 3
Assessment of Infiltration
- Evaluate the extent of infiltration by measuring the affected area 3
- Document the appearance of the site, including any redness, swelling, or discoloration 2
- Assess for pain, which is often the first sign of infiltration 2
- Monitor for signs of tissue damage or necrosis 3
Specific Considerations for Lipid Emulsions
- Lipid emulsions are less irritating to tissues than many other IV medications but still require prompt intervention when infiltrated 1
- The risk of tissue damage is lower with lipid emulsions compared to vesicant medications, but proper management is still essential 3
- Monitor for signs of fat overload syndrome if significant amounts of lipids have infiltrated (headaches, fever, jaundice, respiratory distress) 1, 4
Follow-up Care
- Monitor the site for at least 24 hours for progression of symptoms 3
- Check triglyceride levels if a large volume of lipids has infiltrated, especially in high-risk patients (e.g., preterm infants, malnourished patients) 5, 4
- Consider more frequent monitoring of triglyceride levels in patients who experienced significant infiltration 5
- Document the event thoroughly, including the approximate volume infiltrated, appearance of the site, and interventions performed 2
Prevention Strategies for Future IV Therapy
- Use appropriate catheter stabilization devices to prevent movement that could lead to infiltration 5
- Consider continuous infusion using nutritional pumps for parenteral nutrition containing lipids 5
- Change intravenous tubing used for lipid emulsions every 24 hours to prevent complications 5
- Educate patients to report any pain or discomfort at the IV site immediately 2
- Monitor IV sites frequently, especially when administering lipid emulsions 4
Special Considerations
- In pediatric patients, especially neonates and infants, be particularly vigilant as they are more susceptible to complications from infiltration 5, 6
- For patients requiring long-term parenteral nutrition, consider central venous access to reduce the risk of infiltration 1
- If the infiltration is severe or involves a large volume, consult with a physician or wound care specialist for further management 3