Ischemia of the Hand Secondary to Levarterenol Bitartrate Extravasation
- 18 April 1966
- journal article
- research article
- Published by American Medical Association (AMA)
- Vol. 196 (3) , 288-290
- https://doi.org/10.1001/jama.1966.03100160138046
Abstract
LEVARTERENOL (Levophed) bitartrate is a potent vasoconstrictor frequently used in the management of nonhemorrhagic shock. Ischemic necrosis of the skin secondary to extravasation of the drug is a frequent occurrence.1-4In the severely ill patient, a paucity of veins may necessitate use of the vessels on the dorsum of the hand for levarterenol infusion. This paper reports two cases of levarterenol extravasation into the dorsum of the hand resulting in complete venous occlusion of the hand and ischemic necrosis of the digits. Complete venous occlusion in these cases resulted from compression of the dorsal and volar venous systems by progressive edema beginning on the dorsum of the hand and spreading into the palmar spaces. A method for reversal of this occlusive process is presented. Report of Cases Case 1.— This patient was administered levarterenol while undergoing evacuation of an epidural hematoma. The intravenous fluids infiltrated, and approximately 75 ccKeywords
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