Skin Necrosis after a Low-Dose Vasopressin Infusion through a Central Venous Catheter for Treating Septic Shock.
10.3904/kjim.2006.21.4.287
- Author:
Eun Hee KIM
1
;
Sae Hwan LEE
;
Seung Woon BYUN
;
Ho Suk KANG
;
Dong Hoe KOO
;
Hyun Gu PARK
;
Sang Bum HONG
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. sbhong@amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Arginine vasopressin;
Septic shock;
Necrosis
- MeSH:
Vasopressins/administration & dosage/*adverse effects/therapeutic use;
Vasoconstrictor Agents/administration & dosage/*adverse effects/therapeutic use;
Skin/*drug effects/*pathology;
Shock, Septic/*drug therapy;
Necrosis/chemically induced/pathology;
Male;
Infusions, Intravenous;
Humans;
Fatal Outcome;
Dose-Response Relationship, Drug;
Catheterization, Central Venous;
Aged, 80 and over
- From:The Korean Journal of Internal Medicine
2006;21(4):287-290
- CountryRepublic of Korea
- Language:English
-
Abstract:
This is a report on a case of severe skin necrosis in a vasodilatory septic shock patient after the infusion of low-dose vasopressin through a central venous catheter. An 84-year-old male was hospitalized for edema on both legs at Asan Medical Center, Seoul, Korea. On hospital day 8, the patient began to complain of dyspnea and he subsequently developed severe septic shock caused by E. coli. After being transferred to the medical intensive care unit, his hypotension, which was refractory to norepinephrine, was controlled by an infusion of low-dose vasopressin (0.02 unit/min) through a central venous catheter into the right subclavian vein. After the infusion of low-dose vasopressin, severe skin necrosis with bullous changes developed, necessitating discontinuation of the low-dose vasopressin infusion. The patient expired from refractory septic shock. Although low-dose vasopressin can control hypotension in septic shock patients, low-dose vasopressin must be used with caution because ischemic complications such as skin necrosis can develop even with administration through a central venous catheter.
