Infiltration (medical)

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Infiltration is the diffusion or accumulation (in a tissue or cells) of substances not normal to it or in amounts in excess of the normal. The material collected in those tissues or cells is called infiltrate.

Classification[edit]

As part of a disease process, infiltration is sometimes used to define the invasion of cancer cells into the underlying matrix or the blood vessels. Similarly the term may describe the deposition of amyloid protein. During leukocyte extravasation white blood cells move in response to cytokine chemicals (chemotaxis), from within the blood out to infiltrate into the diseased or infected tissues. The presence of lymphocytes in tissue in greater than normal numbers is likewise called infiltration.

As part of medical intervention, local anaesthetics may be injected at more than one point so as to infiltrate an area prior to a surgical procedure. However the term may also apply to unintended iatrogenic leakage of fluids from phlebotomy or intravenous drug delivery procedures, a process also known as extravasation or "tissuing".

Tissuing[edit]

Infiltration, or tissuing, describes leakage of fluids or blood from damaged blood vessels as a result of medical interventions.

Aetiology[edit]

Infiltration may be caused by:

Signs/Symptoms[edit]

The signs and symptoms of infiltration include:

Clinical Criteria for Grading[edit]

GradeSkin appearanceEdemaSkin on examinationSymptoms
0.No symptoms
1.Skin blanchedEdema <1 inch in any directionCool to touchWith or without pain
2.Skin blanchedEdema 1-6 inches in any directionCool to touchWith or without pain
3.Skin blanched, translucentGross edema >6 inches in any directionCool to touchMild-moderate pain
Possible numbness
4.Skin blanched, translucent
Skin tight, leaking
Skin discolored, bruised, swollen
Gross edema >6 inches in any direction
Deep pitting tissue edema
Circulatory impairmentModerate-severe pain
Infiltration or any amount of blood product, irritant, or vesicant

Nursing Treatment[edit]

The use of warm compresses to treat infiltration has become controversial. It has been found that cold compresses may be better for some infiltrated infusates. If the infiltration is recent and the solution was hypertonic or had an increased pH, a cold compress can be applied. A warm compress can be applied if a small amount of non-caustic solution has infiltrated over a long period, or if the solution is isotonic with normal pH.

It has also been documented that elevation of the infiltrated extremity may be painful for the patient.

To act in the best interest of the patient, following IV infiltration, consult with the physician for orders regarding compresses and elevation.

References[edit]