Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO

We report a case of a 64-year-old woman who was admitted to intensive care unit with multiorgan failure secondary to Plasmodium falciparum malaria. Haemodynamic monitoring using the transpulmonary thermodilution with pulse contour analysis system (PiCCO) was achieved via the left brachial artery. Tw...

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Main Authors: Veejay Bagga, Marion Palmer, Ramesh Sadasivan, Govindan Raghuraman
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2013/474358
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author Veejay Bagga
Marion Palmer
Ramesh Sadasivan
Govindan Raghuraman
author_facet Veejay Bagga
Marion Palmer
Ramesh Sadasivan
Govindan Raghuraman
author_sort Veejay Bagga
collection DOAJ
description We report a case of a 64-year-old woman who was admitted to intensive care unit with multiorgan failure secondary to Plasmodium falciparum malaria. Haemodynamic monitoring using the transpulmonary thermodilution with pulse contour analysis system (PiCCO) was achieved via the left brachial artery. Two days later, a flexion deformity of the left hand was noted, and examination revealed left lower arm ischaemia. Removal of the catheter resulted in an immediate improvement of the contracture. However, distal pulses were still absent, and the arm remained ischaemic resulting in a below elbow amputation. This is the first documented case of a persistent limb ischaemia following the insertion of an arterial catheter for haemodynamic monitoring with PiCCO. We therefore highlight the need for regular assessment of limb perfusion after arterial catheterisation for haemodynamic monitoring with PiCCO. In addition, the brachial artery should be avoided, and femoral artery catheterisation is recommended.
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spelling doaj-art-dfb429cb0f6c41aaa9b068856688a2c72025-08-20T02:21:06ZengWileyCase Reports in Critical Care2090-64202090-64392013-01-01201310.1155/2013/474358474358Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCOVeejay Bagga0Marion Palmer1Ramesh Sadasivan2Govindan Raghuraman3Department of Intensive Care Medicine, Birmingham Heartlands Hospital, Apartment 31, Queens View, 88 Park Grange Road, Sheffield, S2 3RY, Birmingham B9 5SS, UKDepartment of Intensive Care Medicine, Birmingham Heartlands Hospital, Apartment 31, Queens View, 88 Park Grange Road, Sheffield, S2 3RY, Birmingham B9 5SS, UKDepartment of Intensive Care Medicine, Birmingham Heartlands Hospital, Apartment 31, Queens View, 88 Park Grange Road, Sheffield, S2 3RY, Birmingham B9 5SS, UKDepartment of Intensive Care Medicine, Birmingham Heartlands Hospital, Apartment 31, Queens View, 88 Park Grange Road, Sheffield, S2 3RY, Birmingham B9 5SS, UKWe report a case of a 64-year-old woman who was admitted to intensive care unit with multiorgan failure secondary to Plasmodium falciparum malaria. Haemodynamic monitoring using the transpulmonary thermodilution with pulse contour analysis system (PiCCO) was achieved via the left brachial artery. Two days later, a flexion deformity of the left hand was noted, and examination revealed left lower arm ischaemia. Removal of the catheter resulted in an immediate improvement of the contracture. However, distal pulses were still absent, and the arm remained ischaemic resulting in a below elbow amputation. This is the first documented case of a persistent limb ischaemia following the insertion of an arterial catheter for haemodynamic monitoring with PiCCO. We therefore highlight the need for regular assessment of limb perfusion after arterial catheterisation for haemodynamic monitoring with PiCCO. In addition, the brachial artery should be avoided, and femoral artery catheterisation is recommended.http://dx.doi.org/10.1155/2013/474358
spellingShingle Veejay Bagga
Marion Palmer
Ramesh Sadasivan
Govindan Raghuraman
Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO
Case Reports in Critical Care
title Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO
title_full Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO
title_fullStr Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO
title_full_unstemmed Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO
title_short Volkman’s Contracture, Persistent Limb Ischaemia, and Amputation: A Complication of Brachial Artery Catheterisation for Haemodynamic Monitoring Using PiCCO
title_sort volkman s contracture persistent limb ischaemia and amputation a complication of brachial artery catheterisation for haemodynamic monitoring using picco
url http://dx.doi.org/10.1155/2013/474358
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