ArticleJournal of orthopaedics
Management of vasopressor induced ischemia.
Article in Journal of orthopaedics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 23 citations in OpenAlex.
- Article
- Lesion Morphology and Technical Success in Diabetic vs. Non-Diabetic Patients with Chronic Limb-Threatening Ischemia Undergoing Endovascular Treatment: A Retrospective Single-Center Study.Medicina (Kaunas, Lithuania) · 2026Article
- Optimizing Timing and Dose of Starting Norepinephrine and Vasopressin in Septic Shock.Life (Basel, Switzerland) · 2026Review
- Association of Hyperbaric Oxygen Therapy with Platelet Reactivity in Patients with Advanced Peripheral Arterial Disease: A Prospective Observational Study.Journal of clinical medicine · 2026Article
- Life-saving but limb-threatening: vasopressor-induced acral ischaemia and necrosis - two cases and review of the literature.Archives of medical sciences. Atherosclerotic diseases · 2026Article
- Intrathecal nicardipine for symptomatic, refractory vasospasm treatment in pediatric patients: a case series.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2025Review
- Reconstructive Surgical Management of Vasopressor-Ischemia Related Distal Extremity Loss.Journal of orthopaedic case reports · 2025Article
- Effects of early high-dose vasopressor administration in patients after aneurysmal subarachnoid hemorrhage: a retrospective single-center study.Acta neurochirurgica · 2025Article
- Autonomic dysfunction and hemodynamic management after acute spinal cord injury: blood pressure targets, perfusion strategies, and emerging therapies.Frontiers in neurology · 2025Review
- The efficacy of hyperbaric oxygen therapy for skin perfusion following peripheral tissue injury due to usage of inotropes and vasopressors: a case report.Clinical and experimental emergency medicine · 2024Article
- MAN VERSUS MACHINE: PROVIDER DIRECTED VERSUS PRECISION AUTOMATED CRITICAL CARE MANAGEMENT IN A PORCINE MODEL OF DISTRIBUTIVE SHOCK.Shock (Augusta, Ga.) · 2024Article
- Alterations to Kidney Physiology during Cardiopulmonary Bypass-A Narrative Review of the Literature and Practical Remarks.Journal of clinical medicine · 2023Review
- Article
- Dynamic Arterial Elastance to Predict Mean Arterial Pressure Decrease after Reduction of Vasopressor in Septic Shock Patients.Life (Basel, Switzerland) · 2022Article
- Achieving Functional Outcomes after Surgical Management of Catastrophic Vasopressor-induced Limb Ischemia.Plastic and reconstructive surgery. Global open · 2022Article
- Botulinum Toxin in the Treatment of Vasopressor-associated Symmetric Peripheral Gangrene.Plastic and reconstructive surgery. Global open · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeWe evaluated a cohort of patients who developed vasopressor-induced limb ischemia and the management options to prevent progression or minimize morbidity of digital necrosis.
methodsWe reviewed all current literature on pressor-induced limb ischemia and report options for the management of patients requiring vasopressors who developed limb ischemia. We then retrospectively reviewed presentation, treatment, and short-term outcomes for patients at our tertiary referral academic medical center that developed this complication. Finally, we recommend guidelines for the tiered management of these complex patients.
resultsThirty-six patients were included. Twenty-six patients (72%) required resuscitation with more than one vasopressor. Vasopressors were initiated for septic-shock (52.7%), cardiogenic-shock (16.7%), hypovolemic-shock (13.9%), acute transplant rejection (13.9%), and neurogenic-shock (2.8%). According to the tiered management recommendations, patients were managed with phase 1 care (19%), phase 2 care (8.3%), phase 3 care (50%) or phase 4 care (5.6%). The patient expired in the acute setting in 13.9% of cases.
conclusionLife-saving vasopressors risk digital ischemia and necrosis. Early recognition, reporting, and treatment of this complication are important in minimizing morbidity. Using a tiered approach helps organize the healthcare team's management of this iatrogenic complication while respecting the treatment paradigm of "life over limb," and may be safely performed with acceptable outcomes.
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