Infiltration is the diffusion

Diffusion

Molecular diffusion, often called simply diffusion, is the thermal motion of all particles at temperatures above absolute zero. The rate of this movement is a function of temperature, viscosity of the fluid and the size of the particles...

 or accumulation

Accumulation

Accumulation may refer to:* Accumulation: None, a 2002 lo-fi album* Capital accumulation, the gathering of objects of value* Glacier ice accumulation, an element in the glacier mass balance formula...

 (in a tissue

Biological tissue

Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

 or cell

Cell (biology)

The cell is the basic structural and functional unit of all known living organisms. It is the smallest unit of life that is classified as a living thing, and is often called the building block of life. The Alberts text discusses how the "cellular building blocks" move to shape developing embryos....

s) of substances not normal to it or in amounts in excess

Excess

Excess may refer to:* Angle excess, in spherical trigonometry, quantity, used to calculate the area of polygon on a sphere* Excess, in insurance, similar to deductible* Excess, in chemistry, describing any reagent that is not the limiting reagent...

 of the normal. The material collected in those tissues or cells is called infiltrate.

Classification

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

Cancer

Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

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

Amyloid

Amyloids are insoluble fibrous protein aggregates sharing specific structural traits. Abnormal accumulation of amyloid in organs may lead to amyloidosis, and may play a role in various neurodegenerative diseases.-Definition:...

 protein. During leukocyte extravasation

Leukocyte extravasation

Leukocyte extravasation is the movement of leukocytes out of the circulatory system, towards the site of tissue damage or infection. This process forms part of the innate immune response, involving the recruitment of non-specific leukocytes...

 white blood cell

White blood cell

White blood cells, or leukocytes , are cells of the immune system involved in defending the body against both infectious disease and foreign materials. Five different and diverse types of leukocytes exist, but they are all produced and derived from a multipotent cell in the bone marrow known as a...

s move in response to cytokine

Cytokine

Cytokines are small cell-signaling protein molecules that are secreted by the glial cells of the nervous system and by numerous cells of the immune system and are a category of signaling molecules used extensively in intercellular communication...

 chemicals (chemotaxis

Chemotaxis

Chemotaxis is the phenomenon in which somatic cells, bacteria, and other single-cell or multicellular organisms direct their movements according to certain chemicals in their environment. This is important for bacteria to find food by swimming towards the highest concentration of food molecules,...

), from within the blood out to infiltrate into the diseased or infected tissues. The presence of lymphocyte

Lymphocyte

A lymphocyte is a type of white blood cell in the vertebrate immune system.Under the microscope, lymphocytes can be divided into large lymphocytes and small lymphocytes. Large granular lymphocytes include natural killer cells...

s 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

Extravasation

Extravasation is the accidental administration of intravenously infused medicinal drugs into the surrounding tissue, either by leakage , or direct exposure...

or "tissuing".

Tissuing

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

Aetiology

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 the selection of which venous site is used.
• Improper cannula size or excessive delivery rate of the fluid

Signs/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.

Clinical Criteria for Grading

Grade	Skin appearance	Edema	Skin on examination	Symptoms
0.	No symptoms
1.	Skin blanched	Edema <1 inch in any direction	Cool to touch	With or without pain
2.	Skin blanched	Edema 1-6 inches in any direction	Cool to touch	With or without pain
3.	Skin blanched, translucent	Gross edema >6 inches in any direction	Cool to touch	Mild-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 impairment	Moderate-severe pain Infiltration or any amount of blood product, irritant, or vesicant

Nursing Treatment

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 and warm compresses may be more effective for others. 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.