去甲肾上腺素诱导的外周缺血导致坏疽：病例系列。

Norepinephrine-Induced Peripheral Ischemia Leading to Gangrene: A Case Series.

机构信息

Michael Wilson, BS, is Medical Student, Wright State University, Boonshoft School of Medicine, Dayton, Ohio. Kristin Schafer, MD, and Eric Goldschmidt, MD, are Medical Residents, University of Toledo Medical Center, Toledo, Ohio. Benita Wu, BS, is Medical Student, Wright State University, Boonshoft School of Medicine. Richard Simman, MD, FACS, FACCWS, is Plastic and Reconstructive Surgeon, Jobst Vascular Institute, Toledo. Acknowledgments: The authors thank Dr Jeffrey Travers for his contributions to this project. This study was presented as a poster titled "Wounds Resulting From Local and Systemic Effects of Vasopressors: A Case Series" at the Symposium for Advanced Wound Care Fall, November 2018, in Las Vegas, NV. The authors have disclosed no financial relationships related to this article. Submitted October 30, 2019; accepted in revised form August 10, 2020.

出版信息

Adv Skin Wound Care. 2021 May 1;34(5):273-277. doi: 10.1097/01.ASW.0000741528.49437.2c.

DOI:10.1097/01.ASW.0000741528.49437.2c

PMID:33852464

Abstract

Norepinephrine is used in the acute care setting to establish and maintain hemodynamic stability in patients with hypotension. Although it is often a lifesaving medication, norepinephrine may lead to profound vascular insufficiency in the extremities, resulting in dry gangrene and skin necrosis. The purpose of this article is to present a case series of skin complications related to treatment with norepinephrine and review the pathophysiology behind these complications. The authors also explore risk stratification as it relates to history and clinical presentation with subsequent focus on contingencies to mitigate the adverse effects of vasoconstriction on peripheral tissues.

摘要

去甲肾上腺素在急性护理环境中用于建立和维持低血压患者的血流动力学稳定性。虽然它通常是一种救命药物，但去甲肾上腺素可能导致四肢严重血管不足，导致干性坏疽和皮肤坏死。本文的目的是介绍一系列与去甲肾上腺素治疗相关的皮肤并发症，并回顾这些并发症背后的病理生理学。作者还探讨了与病史和临床表现相关的风险分层，随后重点关注减轻血管收缩对周围组织的不良影响的应对措施。