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Crural amputation of a newborn as a consequence of intraosseous needle insertion and calcium infusion
Gorm Erlend Oesterlie1, Klaus Kjaer Petersen, Lars Knudsen
1From the Departments of *Orthopaedic Surgery, †Anesthesia and Intensive Care, and ‡Pediatrics, Aarhus University Hospital, Aarhus, Denmark.
Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. We present a case of a newborn girl, where intraosseous cannulation of the tibia was lifesaving. Despite following most standard recommendations, the treatment resulted in transtibial amputation due to necrosis. We suspect that the necrosis was a consequence of extravasation of tissue-toxic calcium infusion.
Intraosseous needle insertion and infusion is considered an easy and reliable method of achieving a vascular access in acute circulatory collapse where other methods have not been successful within reasonable time. Complications are considered few but may be serious. We present a case of a newborn girl, where intraosseous cannulation of the tibia was lifesaving. Despite following most standard recommendations, the treatment resulted in transtibial amputation due to necrosis. We suspect that the necrosis was a consequence of extravasation of tissue-toxic calcium infusion.