Neonatal acute limb ischemia

Bonny-Obro, Rebecca; Aké, Yapi Landry; Midekor-Gonebo, K.; Kouassi-Dria, Amenan Kan Sophie; Ouattara, Sigué Jean Jaurès; Sounkere-Soro, Moufidath; Dibi, Kokora Xavier; Moh, E.N.

doi:10.1016/j.epsc.2021.101784

Journal of Pediatric Surgery Case Reports

2021

DOI: 10.1016/j.epsc.2021.101784

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Neonatal acute limb ischemia

Rebecca Bonny-Obro

Yapi Landry Aké

K. Midekor-Gonebo

et al.

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2024

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Cited by 2 publications

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Management of iatrogenic acute limb ischaemia in the neonate

Shaniv,

Simpson-Lavy,

Hershkovich Shporen

2024

BMJ Case Rep

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Iatrogenic acute limb ischaemia (ALI) in neonates is a rare but severe event with potentially deleterious outcomes. In the neonatal intensive care unit, this risk is increased due to the high rate of catheterisation procedures. ALI management includes pharmacological and non-pharmacological interventions, but no commonly accepted clinical guidelines are available. In the present case, a peripheral catheter was erroneously placed in the left brachial artery of a term infant, causing blockage and ischaemia in the limb. The catheter was immediately removed, the affected limb was elevated and warm compresses were applied to the contralateral limb. The patient was treated with fresh frozen plasma, heparin, iloprost and topical nitroglycerin. Three nerve block procedures were also performed. At 6–8 days of age, significant improvement was observed. The patient was discharged at 17 days of age with near-complete resolution, whereas complete resolution was observed at postdischarge follow-up.

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Management of iatrogenic acute limb ischaemia in the neonate

Shaniv,

Simpson-Lavy,

Hershkovich Shporen

2024

BMJ Case Rep

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Unilateral Upper Extremity Ischemia in a Neonate – A Rare Complication of Prematurity

Iyer¹,

Agrawal²,

Sakale³

et al. 2022

Journal of Orthopedics, Traumatology and Rehabilitation

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Acute limb ischemia in the neonatal period is a rarely reported complication of prematurity and needs a high index of suspicion for early diagnosis and a multidisciplinary approach for its management. Here, we present a case of a preterm baby that developed unilateral upper limb ischemia in the neonatal period and discussed the problems faced in the management of such cases. A 24-day-old male baby was referred to the orthopedics department because of bluish-black discoloration of the right hand and forearm and no active movement in the wrist and hand. The baby was preterm, delivered at 29 weeks of gestation lower-segment cesarean section with a birth weight of 900 g to a healthy mother with no preexisting illness. Although the line of demarcation was just below the elbow joint and conventional wisdom would dictate us to go for a transhumeral amputation, we opted for a below elbow amputation in a bid to save the elbow joint as we could have revised the amputation at a later date if needed. Neonatal acute limb ischemia has been rarely reported and needs a high index of suspicion. Preterm and low birth weight babies are more prone to it. Treatment of such patients depends on the cause of gangrene. Amputation at such young age is psychologically disturbing for the parents. However, it is usually associated with good functional outcomes as the child has not yet learned the use of a limb or developed cortical plasticity in the brain. All attempts should be made to preserve as much joint and physis as possible to have a functional joint with better prosthetic fitting.

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Neonatal acute limb ischemia

Cited by 2 publications

References 10 publications

Management of iatrogenic acute limb ischaemia in the neonate

Management of iatrogenic acute limb ischaemia in the neonate

Unilateral Upper Extremity Ischemia in a Neonate – A Rare Complication of Prematurity

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