Papaverine for Ischemia Following Peripheral Arterial Catheterization in Neonates

Area of Science:

• Neonatal Medicine
• Vascular Pharmacology
• Pediatric Dermatology

Background:

• Peripheral arterial catheterization is a common procedure in extremely low birth weight (ELBW) neonates.
• Skin discoloration is a potential complication following this procedure.
• Vascular compromise can lead to serious adverse outcomes in neonates.

Purpose of the Study:

• To evaluate the efficacy of intra-arterial papaverine in reversing skin discoloration caused by peripheral arterial catheterization in ELBW neonates.
• To assess the safety and effectiveness of papaverine in preventing long-term complications.

Main Methods:

• A cohort of 11 ELBW neonates with skin discoloration post-arterial catheterization received intra-arterial papaverine.
• Papaverine was administered prior to arterial line removal.
• A control group of 3 neonates did not receive papaverine.

Main Results:

• All 11 neonates treated with papaverine showed complete resolution of skin discoloration.
• No residual skin damage was observed in the papaverine-treated group.
• One of the 3 neonates not receiving papaverine developed finger gangrene.

Conclusions:

• Intra-arterial papaverine is a safe and effective treatment for peripheral arterial catheterization-induced skin discoloration in ELBW neonates.
• Early intervention with papaverine can prevent severe complications such as gangrene.
• Papaverine should be considered in the management of this iatrogenic complication.