Factors predisposing to limb ischemia among critically ill patients receiving inotropes

Abstract

Background Critically ill patients receiving positive inotropes are at risk for developing many complications, of these is peripheral limb ischemia. Therefore, they require assessment, prevention, early detection, and management that might shorten hospital stay and improve patient outcomes. Aim To assess factors predisposing to limb ischemia among critically ill patients receiving positive inotropes. Research design A descriptive exploratory research design was utilized in this study. Results Severe peripheral/limb ischemia affected 70.6% of the studied participants. It was most frequently found in the right and left lower limbs at a percentage of 81.6 and 79.4%, respectively. Limb ischemia was most frequently noticed among male patients in the age group of 50–60 years old, who had comorbid diseases such as diabetes and hypertension. Many factors predisposes the patient to limb ischemia such as intravenous administration of both epinephrine and norepinephrine at a percentage of 81.6%, with a significant statistical relationship between limb ischemia and positive inotrope administration (χ 2=31.52, P≤0.000), epinephrine doses (χ 2=43.53, P≤0.000), and norepinephrine doses (χ 2=69.55, P≤0.000): smoking (χ 2=12.46, P≤0.002), family history (χ 2=24.01, P≤0.000), total cholesterol level (χ 2=7.64, P≤0.022), BMI (χ 2=55.02, P≤0.000), and comorbidities (χ 2=20.55, P≤0.002). Conclusion Based on the findings of this study, it can be concluded that limb ischemia is a common problem among critically ill patients receiving positive inotropes. Therefore, continuous and strict assessment could play an important role in its prevention and early detection. Recommendations Closed observation for patients receiving inotrope infusions, especially for those at risk for developing limb ischemia, and replication of this study on a larger probability sample selected from different geographical areas in Egypt.