J Korean Soc Surg Hand.
2012 Sep;17(3):137-141.
Ischemic Necrosis of the Upper and Lower Extremities after the Use of Norepinephrine
- Affiliations
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- 1Department of Plastic and Reconstructive Surgery, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. pssroh@jbnu.ac.kr
Abstract
- PURPOSE
Norepinephrine is initially used to increase blood pressure in patients with septic shock. It increases blood flow to vital organs but decrease the flow to end-organs resulting in ischemic changes in end-organs. We report five patients with ischemic necrosis of upper and lower extremities after using norepinephrine in septic shock.
MATERIALS AND METHODS
We retrospectively reviewed medical record of five patients with ischemic necrosis of upper and lower extremities after treating septic shock from March 2010 to March 2011.
RESULTS
Five patients developed ischemic necrosis of upper and lower extremities during intensive care. All patients experienced septic shock due to medical problems, which required norepinephrine to increase blood pressure. After conservative treatment, stump revision or below knee amputation were done.
CONCLUSION
We believe that more active treatment and protection of the end-organs will be needed to prevent poor prognosis during the recovery of septic shock.
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