頁籤選單縮合
題名 | Symmetrical Peripheral Gangrene after Using High-dose Inotropes |
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作者 | Tsai Pai, Mei-an; Chien, Shiaw-wen; Kuo, Yuan-chuan; Wu, Tsai-kun; Chen, Chang-hsu; Lim, Paik-seong; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷期 | 27:1 2013.03[民102.03] |
頁次 | 頁48-51 |
分類號 | 415.74 |
關鍵詞 | Symmetrical peripheral gangrene; SPG; Inotropes; Urosepsis; |
語文 | 英文(English) |
英文摘要 | Symmetrical peripheral gangrene (SPG) is an uncommon but devastating complication in critically ill patients with a high mortality. It is seen in a wide variety of medical conditions, presenting as symmetrical gangrene of two or more extremities without large vessel obstruction. We hereby report a 65-year-old woman diagnosed of having E. coli bacteremia with urosepsis, who presented with acute abdomen, consciousness disturbance and multiple organ failure. Owing to low blood pressure and unstable hemodynamic status, inotropic agents with maximum dose of dopamine at 12.7 g/kg/min and levophed of 2.6 g/min were used. On the 4th day of admission, patient developed cyanosis and gangrene of fingers and toes. However, even with the dose of inotropic agents tapered, the cyanosis and gangrene did not resolve. Autoamputation developed and the patient underwent multiple surgical amputations of her fingers and toes. Patient also developed acute kidney injury with anuria and pulmonary edema, thus necessitating hemodialysis treatment. |
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