Vasopressor-Induced Peripheral Gangrene Secondary to COVID-19: A Case Report

Area of Science:

• Vascular Surgery
• Critical Care Medicine
• Pharmacology

Background:

• Lower-extremity amputations are a significant healthcare concern, with ischemia being a major contributing factor.
• Ischemia is an infrequent but serious complication of vasopressor therapy, often used for life-threatening hypotension.
• Limited research and treatment guidelines exist for vasopressor-induced ischemia.

Observation:

• A 37-year-old male patient with severe COVID-19 required vasopressor medication.
• The patient developed ischemic changes in his bilateral forefeet and hands due to vasopressor use.
• Ischemic changes typically manifest several days after vasopressor initiation.

Findings:

• The case study highlights the potential for limb salvage despite severe ischemic complications from vasopressors.
• A prolonged demarcation period allowed for careful assessment of tissue viability.
• Multidisciplinary collaboration was crucial in managing the patient's complex condition.

Implications:

• This case suggests that immediate amputation may not be the optimal approach for vasopressor-induced ischemia.
• Preserving limbs through careful monitoring and specialized care can maintain patient functionality.
• Further research is needed to establish evidence-based guidelines for managing this complication.