Resolution of peripheral artery catheter-induced ischemic injury following prolonged treatment with topical nitroglycerin ointment in a newborn: a case report.
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.
Vasquez
Pedro
P
Department of Pediatrics/Neonatology, UMDNJ-Robert Wood Johnson Medical School, Saint Peter's University Hospital, New Brunswick, NJ 08901, USA.
Burd
Angela
A
Mehta
Rajeev
R
Hiatt
Mark
M
Hegyi
Thomas
T
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*
D014665:Vasodilator Agents; D005996:Nitroglycerin