Vasquez Pedro, Burd Angela, Mehta Rajeev, Hiatt Mark, Hegyi Thomas
Department of Pediatrics/Neonatology, UMDNJ-Robert Wood Johnson Medical School, Saint Peter's University Hospital, New Brunswick, NJ 08901, USA.
J Perinatol. 2003 Jun;23(4):348-50. doi: 10.1038/sj.jp.7210870.
Tissue ischemia, necrosis, and gangrene are uncommon but well-described complications of arterial catheterization in the neonate. Treatment options for progressive tissue necrosis following arterial embolization and/or vasospasm are limited in these patients secondary to unpredictable pharmacokinetics and risks associated with systemic anticoagulation or vasodilatation in newborns. We report a case of a multidose regimen of topical 2% nitroglycerin ointment for reversing severe tissue ischemia following peripheral arterial line placement. The favorable response in this infant suggests that topical nitroglycerin therapy should be considered as potential therapy to ameliorate the effects of vascular compromise following arterial line placement in neonates.
组织缺血、坏死和坏疽在新生儿动脉导管插入术中虽不常见,但已有详细描述。由于新生儿药代动力学不可预测以及全身抗凝或血管扩张相关风险,这些患者在动脉栓塞和/或血管痉挛后出现进行性组织坏死的治疗选择有限。我们报告了一例使用多剂量2%硝酸甘油软膏局部治疗,以逆转外周动脉置管后严重组织缺血的病例。该婴儿的良好反应表明,局部硝酸甘油治疗应被视为改善新生儿动脉置管后血管损伤影响的潜在治疗方法。