IV Infiltration Detection

Omer Inan, PhD, and his team are working to tackle IV infiltration, an issue physicians and nurses encounter frequently, including at children’s hospitals. IV therapy is used in 80-90% of hospitalized patients, and involves placing a catheter into the vein to deliver fluids, medications and nutrients directly into the bloodstream. IV infiltration – the accidental leakage of fluid out of the veins into the tissue – occurs in some patients with IVs, and in the most severe form, it is considered a medical emergency. This occurrence can especially be a big issue for children because it occurs more frequently than it does in adults, and the damage to the skin and tissue can be more significant. Kids move around a lot even when the peripheral IV site is dressed and secured.  When the catheter dislodges from the vein, there is a risk of the substance running through the catheter to leak out of the vein, and into the surrounding tissue, tendons or even muscle beneath. If the infiltration occurs with a vesicant fluid or chemotherapeutic drug, it will cause tissue destruction or blistering, which is called extravasation. Once detected, there is little that can be done to reverse the infiltration or salvage the damaged tissue in an extravasation.  The most severe burns may result in tissue sloughing, pain, loss of mobility and risk of infection. Severe extravasations may require surgical intervention and management.

IV infiltration is more common in kids than adults for a variety of reasons, such as the inability to express pain due to the IV site.  In 2014, this problem was brought to Dr. Inan and team’s (Kevin Maher, Saidie Rodriguez, Leanne West, Lynn Pogue, and Amy Parker) attention. As an Associate Professor of Electrical and Computer Engineering at Georgia Tech, Dr. Inan has experience quantifying fluid levels inside the body using technology called bioimpedance. He thus envisioned that such technology could be used to automatically detect an infiltration. Currently, there’s a system in hospitals that is tethered to the wall and has a cable with an optical sensor that examines the tissue and determines if there’s an infiltration; however, a fully wearable system without any tethering would be advantageous.

Dr. Inan and his team’s idea is to create a wearable patch or system that sits at the IV site and sends an alarm to the caregiver once fluid buildup in the surrounding tissues has occurred. They started with prototyping things on the bench top and testing with simple lab experiments. They worked with the Global Center for Medical Innovation to advance the packaging, so it would be safe and usable in hospital settings. After that, they started an observational study at Children’s Healthcare of Atlanta. Results show they might be able to detect infiltrations early, even before caregivers can detect it by the look, touch and compare method.

The inspiration to get involved in this research stemmed from seeing photos of what happens to a child’s skin when infiltration occurs. Dr. Inan says, “as engineers you want to solve important problems, and this is clearly a very important problem.” He hopes his research will help give early and accurate detection of IV infiltration with a wearable device to alert caregiver to reduce the number of infiltration events that become major issues.

The next steps for this research are to get the prototype and manufacturing process ready, discussions with the FDA, starting a clinical trial, demonstrating this technology is safe and can reduce infiltrations, and building wireless technology to send alerts to caregivers.

Funding is still needed to support this research. Dr. Inan and his team hope to use this technology with kids first because they feel that’s where the biggest impact can be. Eventually they want to move this technology to adults because it can also have a big impact on some chemotherapy patients or patients receiving IV therapy at home where there might not be a nurse.