Deldar Romina, Abu El Hawa Areeg A, Haffner Zoe K, Higgins James P, Katz Ryan D, Attinger Christopher E, Evans Karen K
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital; Washington, D.C.
Georgetown University School of Medicine; Washington, D.C.
Plast Reconstr Surg Glob Open. 2022 Mar 7;10(3):e4175. doi: 10.1097/GOX.0000000000004175. eCollection 2022 Mar.
Vasopressor-induced limb ischemia is an unfortunate complication that can occur in patients treated for septic shock. Current literature lacks surgical treatment recommendations for this condition, besides amputation. We describe various reconstructive surgeries and functional outcomes in patients treated surgically for vasopressor-induced limb ischemia.
We retrospectively reviewed patients who were treated for septic shock and developed vasopressor-induced limb ischemia at our tertiary referral academic medical center. We reviewed presentation, treatment, surgical outcomes, and long-term functional outcomes.
We present three previously healthy patients who developed gangrene of multiple limbs following the use of vasopressors to treat septic shock. Each patient underwent amputations or limb salvage procedures.
Limb ischemia is a devastating complication that can occur after prolonged vasopressor use. The decision to proceed with limb salvage versus amputation of ischemic extremities should be tailored to the individual patient. The main objective should be for the patient to obtain optimal function and quality of life, regardless of the type of surgery.
血管升压药诱发的肢体缺血是一种不幸的并发症，可发生在感染性休克治疗患者中。除截肢外，目前文献缺乏针对这种情况的手术治疗建议。我们描述了接受手术治疗血管升压药诱发肢体缺血患者的各种重建手术及功能结果。
我们回顾性分析了在我们的三级转诊学术医学中心接受感染性休克治疗并发生血管升压药诱发肢体缺血的患者。我们评估了临床表现、治疗、手术结果及长期功能结果。
我们报告了3例既往健康的患者，在使用血管升压药治疗感染性休克后出现多肢坏疽。每位患者均接受了截肢或保肢手术。
肢体缺血是长时间使用血管升压药后可能出现的灾难性并发症。对于缺血肢体进行保肢还是截肢的决定应根据个体患者情况量身定制。无论手术类型如何，主要目标都应是让患者获得最佳功能和生活质量。
