*University of Michigan Medical School, Ann Arbor, MI.
J Am Podiatr Med Assoc. 2024 May-Jun;114(3). doi: 10.7547/22-216.
Lower-extremity amputations are a major concern for the current state and future of healthcare, with ischemia contributing significantly to this issue. This is an infrequent but serious complication of vasopressor use. Unfortunately, there is little research existing on the topic and even fewer guidelines on treatment options. Vasopressors are often used to treat life-threatening hypotension. However, ischemic changes associated with vasopressor use often do not present for several days. It is frequently recommended that patients undergo amputation when the first signs of ischemia occur. This approach, however, does not allow for the full process of demarcation, making it difficult to determine which portions of the lower extremity will remain viable. This is a case study of a 37-year-old man who developed severe complications from COVID-19 and was subsequently admitted. Because of a complicated hospital course, he required the use of vasopressor medication that subsequently led to the development of ischemic changes to his bilateral forefeet and hands. Through a prolonged period of demarcation and the collaboration of multiple specialties, the patient was able to salvage each limb and maintain his functionality.
下肢截肢是当前医疗保健状况和未来的主要关注点，而局部缺血是导致这一问题的主要原因。这是使用升压药的一种罕见但严重的并发症。不幸的是，关于这个主题的研究很少，关于治疗选择的指南就更少了。升压药通常用于治疗危及生命的低血压。然而，与升压药使用相关的局部缺血变化通常在数天内不会出现。通常建议患者在出现局部缺血的最初迹象时进行截肢。然而，这种方法不允许进行完全的分界过程，因此很难确定下肢的哪些部分仍具有活力。这是一名 37 岁男子的病例研究，他因 COVID-19 而出现严重并发症，随后被收治入院。由于病情复杂，他需要使用升压药物，随后导致双侧前足和手部出现局部缺血变化。通过长时间的分界过程和多个专业的合作，患者得以挽救每个肢体并保持其功能。
