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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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| 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. |
| format | Article |
| id | doaj-art-dfb429cb0f6c41aaa9b068856688a2c7 |
| institution | OA Journals |
| issn | 2090-6420 2090-6439 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| 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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