An Algorithmic Approach to the Management of Limb Ischemia in Infants and Young Children

• DOI: 10.1097/prs.0b013e31827c6e66
• Publication Date: 2012-11-17T08:17:53Z
• Authors: Cara Downey; Oluseyi Aliu; Stephanie Nemir; Bindi Naik-Mathuria; Daniel A. Hatef; Jamal M. Bullocks; Jeffrey D. Friedman
• Keywords: Vascular surgery; Medical record; Limb loss

Vascular injuries in newborns are rare and most commonly occur the process of obtaining vascular access for monitoring organ system functions or interventions critical care. Care neonates poses several challenges, with significant arguably being lack clinical experience such injuries. An algorithm management arterial pediatric patients is investigated reported.A retrospective chart analysis was performed on all consulted injury by plastic surgery service at Texas Children's Hospital between 1997 2005. The outcomes procedures were reviewed.Thirty insults 28 evaluated treated senior author (J.D.F.) using this protocol. Thirty-seven percent (11 30) approached surgically, including two cases thrombolysis alone. remaining 63 (19 managed more conservative interventions, anticoagulation optimization. When color Doppler imaging used preoperatively to locate describe characteristics injuries, visualized lesions coincided surgical findings 100 11 cases). Twenty-three limbs (77 percent) salvaged completely algorithm, one initially but later developed limb-length discrepancy requiring amputation, experienced complete limb loss. (five died as a result complications their primary medical conditions before salvage could be assessed.This evaluation demonstrates efficacy proposed determine direction care event small children.