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Limb Necrosis in the Setting of Vasopressor Use.
Derry, Kendall H; Rocks, Madeline C; Izard, Paul; Nicholas, Rebecca S; Sommer, Philip M; Hacquebord, Jacques H.
Afiliación
  • Derry KH; Kendall H. Derry is a resident physician, Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
  • Rocks MC; Madeline C. Rocks is a medical student, George Washington University School of Medicine and Health Sciences, Washington, DC.
  • Izard P; Paul Izard is a medical student, Harvard Medical School, Boston, Massachusetts.
  • Nicholas RS; Rebecca S. Nicholas is an attending physician, Division of Hand Surgery, Department of Orthopedic Surgery, NYU Langone Health, New York, New York.
  • Sommer PM; Philip M. Sommer is an attending physician, Perioperative Care and Pain Medicine Division, Department of Anesthesiology, NYU Langone Health, New York, New York.
  • Hacquebord JH; Jacques H. Hacquebord is an attending physician and chief, Division of Hand Surgery, Department of Orthopedic Surgery, Hansjorg Wyss Department of Plastic Surgery, NYU Langone Health, New York, New York.
Am J Crit Care ; 33(3): 226-233, 2024 May 01.
Article en En | MEDLINE | ID: mdl-38688844
ABSTRACT

BACKGROUND:

It remains poorly understood why only some hemodynamically unstable patients who receive aggressive treatment with vasopressor medications develop limb necrosis.

OBJECTIVE:

To determine the incidence of limb necrosis and the factors associated with it following high-dose vasopressor therapy.

METHODS:

A retrospective case-control medical records review was performed of patients aged 18 to 89 years who received vasopressor therapy between 2012 and 2021 in a single academic medical center. The study population was stratified by the development of limb necrosis following vasopressor use. Patients who experienced necrosis were compared with age- and sex-matched controls who did not experience necrosis. Demographic information, comorbidities, and medication details were recorded.

RESULTS:

The incidence of limb necrosis following vasopressor administration was 0.25%. Neither baseline demographics nor medical comorbidities differed significantly between groups. Necrosis was present in the same limb as the arterial catheter most often for femoral catheters. The vasopressor dose administered was significantly higher in the necrosis group than in the control group for ephedrine (P = .02) but not for the other agents. The duration of therapy was significantly longer in the necrosis group than in the control group for norepinephrine (P = .001), epinephrine (P = .04), and ephedrine (P = .01). The duration of vasopressin administration did not differ significantly between groups.

CONCLUSION:

The findings of this study suggest that medication-specific factors, rather than patient and disease characteristics, should guide clinical management of necrosis in the setting of vasopressor administration.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vasoconstrictores / Necrosis Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Crit Care Asunto de la revista: ENFERMAGEM / TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vasoconstrictores / Necrosis Límite: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Am J Crit Care Asunto de la revista: ENFERMAGEM / TERAPIA INTENSIVA Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos