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Inadvertent extravasations of norepinephrine.

Ravi Ranjan Pradhan1

  • 1Department of Internal Medicine Madesh Institute of Health Sciences Janakpurdham Nepal.

Clinical Case Reports
|October 26, 2022
PubMed
Summary
This summary is machine-generated.

Norepinephrine extravasation during infusion for diabetic ketoacidosis and septic shock caused skin tissue ischemia. Prompt wound care and debridement led to patient recovery, highlighting risks of peripheral norepinephrine administration.

Keywords:
bulladebridementinadvertent extravasationsnorepinephrinetissue necrosis

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Area of Science:

  • Critical Care Medicine
  • Pharmacology
  • Dermatology

Background:

  • Diabetic ketoacidosis and septic shock are life-threatening conditions requiring vasopressor support.
  • Norepinephrine is a common vasopressor used to manage hypotension in critical illness.
  • Peripheral intravenous administration is a common route for drug delivery.

Observation:

  • A patient with diabetic ketoacidosis and septic shock developed skin necrosis and bulla formation.
  • These complications occurred after norepinephrine infusion via a peripheral intravenous line.
  • The extravasation of norepinephrine was implicated as the cause of tissue ischemia.

Findings:

  • Inadvertent extravasation of norepinephrine can lead to severe local tissue ischemia and necrosis.
  • Higher concentrations of norepinephrine administered peripherally may increase the risk of vasoconstriction and ischemia.
  • The patient's condition improved with conservative management, including wound debridement and dressing.

Implications:

  • Careful monitoring of peripheral intravenous lines during norepinephrine infusion is crucial.
  • Consideration should be given to the concentration and administration route of norepinephrine to minimize extravasation risks.
  • Early recognition and management of extravasation can prevent severe tissue damage.