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Case Report
- Skin Necrosis after High Dose Vasopressor Infusion in Septic Shock: Two Case Reports
- Ah Reum Cho, Jeung Il Kim, Eun Jung Kim, Seung Min Son
- Korean J Crit Care Med. 2012;27(3):182-186.
- DOI: https://doi.org/10.4266/kjccm.2012.27.3.182
- 5,497 View
- 1,882 Download
- 6 Crossref
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Abstract
PDF - Survival sepsis campaign recommends that vasopressor therapy is required to maintain mean arterial pressure (MAP) > or = 65 mmHg. However, the absolute maximum dose of vasopressor is difficult to determine. Herein, we report 2 cases of severe skin necrosis after high dose vasopressor infusion to maintain the recommended MAP in septic shock. In our first case, norepinephrine 1.0-2.0 microg/kg/min and vasopressin 0.03-0.1 U/min were infused for 5 days; in the second case, dopamine 10-20 microg/kg/min and norepinephrine 0.25-2.5 microg/kg/min were infused for 7 days. Severe ischemic skin lesions, which required amputations, developed in both cases. The clinical appearance of the skin lesions in the 2 cases was different because of the unique distribution of target receptors for different vasopressors. Thus, when high dose vasopressors are required to achieve recommended MAP, extra vigilance is required. Further studies for dose adjustment are needed.
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Citations
Citations to this article as recorded by
- Local α-receptor antagonists as a targeted therapeutic approach in patients with vasopressor-induced symmetrical peripheral gangrene
Philipp Edmund Lamby, Vinzent Forstmeier, Lukas Prantl, Michael Pawlik, Jasmin Lenhard
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BMJ Case Reports.2017; 2017: bcr-2017-220730. CrossRef - Upper Extremity Complications and Concerns in Patients With Cardiac Disease
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- Local α-receptor antagonists as a targeted therapeutic approach in patients with vasopressor-induced symmetrical peripheral gangrene
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