Infiltration is the

diffusion Diffusion is the net movement of anything (for example, atoms, ions, molecules, energy) generally from a region of higher concentration to a region of lower concentration. Diffusion is driven by a gradient in Gibbs free energy or chemical p ...

accumulation Accumulation may refer to: Finance * Accumulation function, a mathematical function defined in terms of the ratio future value to present value * Capital accumulation, the gathering of objects of value Science and engineering * Accumulate (hi ...

(in a tissue or

cell Cell most often refers to: * Cell (biology), the functional basic unit of life Cell may also refer to: Locations * Monastic cell, a small room, hut, or cave in which a religious recluse lives, alternatively the small precursor of a monastery ...

s) of foreign substances in amounts excess of the normal. The material collected in those tissues or cells is called infiltrate.

Definitions of infiltration

As part of a disease process, infiltration is sometimes used to define the invasion of

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

cells into the underlying matrix or the blood vessels. Similarly, the term may describe the deposition of

amyloid Amyloids are aggregates of proteins characterised by a Fibril, fibrillar morphology of 7–13 Nanometer, nm in diameter, a beta sheet (β-sheet) Secondary structure of proteins, secondary structure (known as cross-β) and ability to be Staining, ...

protein. During

leukocyte extravasation Leukocyte extravasation (also commonly known as leukocyte adhesion cascade or diapedesis – the passage of cells through the intact vessel wall) is the movement of leukocytes out of the circulatory system and towards the site of tissue damage or ...

white blood cells White blood cells, also called leukocytes or leucocytes, are the cells of the immune system that are involved in protecting the body against both infectious disease and foreign invaders. All white blood cells are produced and derived from mult ...

move in response to

cytokines Cytokines are a broad and loose category of small proteins (~5–25 kDa) important in cell signaling. Cytokines are peptides and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in autocrin ...

from within the blood, into the diseased or infected tissues, usually in the same direction as a chemical gradient,Kumar et al. 2014, p. 36 in a process called

chemotaxis Chemotaxis (from '' chemo-'' + ''taxis'') is the movement of an organism or entity in response to a chemical stimulus. Somatic cells, bacteria, and other single-cell or multicellular organisms direct their movements according to certain chemica ...

. The presence of

lymphocyte A lymphocyte is a type of white blood cell (leukocyte) in the immune system of most vertebrates. Lymphocytes include natural killer cells (which function in cell-mediated, cytotoxic innate immunity), T cells (for cell-mediated, cytotoxic ad ...

s in tissue in greater than normal numbers is likewise called infiltration. As part of medical intervention,

local anaesthetics A local anesthetic (LA) is a medication that causes absence of pain sensation. In the context of surgery, a local anesthetic creates an absence of pain in a specific location of the body without a loss of consciousness, as opposed to a general an ...

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 Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence. "Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 2 ...

leakage of fluids from

phlebotomy Phlebotomy is the process of making a puncture in a vein, usually in the arm, with a cannula for the purpose of drawing blood. The procedure itself is known as a venipuncture, which is also used for intravenous therapy. A person who performs a p ...

or intravenous drug delivery procedures, a process also known as

extravasation __NOTOC__ Extravasation is the leakage of a fluid out of its container into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells from the capillaries to th ...

or "tissuing".

Causes

Infiltration may be caused by: * Puncture of distal vein wall during venipuncture * Puncture of any portion of the vein wall by mechanical friction from the catheter/needle cannula * Dislodgement of the catheter/needle cannula from the intima of the vein which may be a result of a poorly secured IV device or inappropriate choice of venous site to puncture. * Improper cannula size or excessive delivery rate of the fluid

Signs and symptoms

The signs and symptoms of infiltration include: * Inflammation at or near the insertion site with swollen, taut skin with pain * Blanching and coolness of skin around IV site * Damp or wet dressing * Slowed or stopped infusion * No backflow of blood into IV tubing on lowering the solution container.

Grading

Nursing treatment

The use of

warm compresses A warm compress is a method of applying heat to the body. Heating sources can include warm water, microwaveable pads, wheat packs and electrical or chemical pads. Some unorthodox methods can include warmed potatoes, uncooked rice, and hard-boiled ...

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.

Notes

References

* * * * {{cite book , title=Brunner & Suddarth's Textbook of Medical-Surgical Nursing , edition=Twelfth , isbn=0-7817-8590-1 Medical terminology