title: Resolution of peripheral artery catheter-induced ischemic injury following prolonged treatment with topical nitroglycerin ointment in a newborn: a case report.
abstract: 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.
authors.affiliation: Department of Pediatrics/Neonatology, UMDNJ-Robert Wood Johnson Medical School, Saint Peter's University Hospital, New Brunswick, NJ 08901, USA.
authors.forename: Pedro
authors.initials: P
authors.lastname: Vasquez
authors.forename: Angela
authors.initials: A
authors.lastname: Burd
authors.forename: Rajeev
authors.initials: R
authors.lastname: Mehta
authors.forename: Mark
authors.initials: M
authors.lastname: Hiatt
authors.forename: Thomas
authors.initials: T
authors.lastname: Hegyi
mesh_terms: D000287:Administration, Topical; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007511:Ischemia / Q000188:drug therapy* / Q000209:etiology*; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000627:therapeutic use*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin