title: Low-temperature infiltration identified using infrared thermography in patients with subcutaneous edema revealed ultrasonographically: A case report.
abstract: Infiltration is a frequent complication of infusion therapy. We previously demonstrated the usefulness of infrared thermography as an objective method of detecting infiltration in healthy people. However, whether thermography can detect infiltration in clinical settings remains unknown. Therefore, we report two cases where thermography was useful in detecting infiltration at puncture sites. In both cases, tissue changes were verified ultrasonographically. The patients were a 56-year-old male with cholangitis and a 76-year-old female with hepatoma. In both cases, infiltration symptoms such as swelling and erythema occurred one day after the insertion of a peripheral intravenous catheter. Thermographic images from both patients revealed low-temperature areas spreading from the puncture sites; however, these changes were not observed in other patients. The temperature difference between the low-temperature areas and their surrounding skin surface exceeded 1.0°C. Concurrently, ultrasound images revealed that tissues surrounding the vein had a cobblestone appearance, indicating edema. In both patients, subcutaneous tissue changes suggested infiltration and both had low-temperature areas spreading from the puncture sites. Thus, subcutaneous edema may indicate infusion leakage, resulting in a decrease in the temperature of the associated skin surface. These cases suggest that infrared thermography is an effective method of objectively and noninvasively detecting infiltration.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo.
authors.forename: Maiko
authors.initials: M
authors.lastname: Oya
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Hidenori
authors.initials: H
authors.lastname: Tanabe
authors.forename: Makoto
authors.initials: M
authors.lastname: Oe
authors.forename: Ryoko
authors.initials: R
authors.lastname: Murayama
authors.forename: Koichi
authors.initials: K
authors.lastname: Yabunaka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Matsui
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications; D002406:Catheterization, Peripheral / Q000009:adverse effects; D002761:Cholangitis / Q000000981:diagnostic imaging / Q000209:etiology; D004487:Edema / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007259:Infrared Rays; D008113:Liver Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000000981:diagnostic imaging; D040521:Subcutaneous Tissue / Q000000981:diagnostic imaging; D013696:Temperature; D013817:Thermography; D014463:Ultrasonography