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 chemica ...
or
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 fibrillar morphology of 7–13 nm in diameter, a beta sheet (β-sheet) secondary structure (known as cross-β) and ability to be stained by particular dyes, such as Congo red. In the huma ...
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 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. 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 27 ...
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