Ali BİLGE, Murat TOPAL, Muhammed Çağatay ENGİN, Ahmet KÖSE, İbrahim Avşin ÖZTÜRK

Brakial Arter Kateterizasyonu Sonucu Oluşan Bilateral Pembe Nabızsız El

İntravenöz kateterler acil servislerde hastaları hidrate etmek, hızlı ilaç uygulamak ve tek bir invaziv işlem ile seri kan örneği almak için en kullanışlı araçlardır. Venöz kateterler kazara artere uygulanabilmektedir ve bu durum klinikte nabızsız el tablosuna neden olabilmektedir. Pembe nabızsız elin takibi ekstremiteyi kurtarmak için çok önemli bir prosedürdür. Sunmuş olduğumuz vaka üst ekstremitede herhangi bir travma öyküsü olmayan, ancak venöz kateterizasyon sırasında kaza ile arteryel vasküler yaralanmaya sekonder gelişen bilateral pembe nabızsız el ile başvuran 3 günlük infanttır. Pembe nabızsız el tedavisi hala literatürde tartışmalıdır. Yakın izlem uygulanabilen pembe nabızsız el olgularında yakın takip uygulanabilir ve cerrahi eksplorasyon olmadan iyi sonuçlar elde edilebilmektedir.

Bilateral Pink Pulseless Hand as a Result of Brachial Artery Catheterisation

In emergency services, Intravenous catheters are most useful instruments to hidratepatients, administrate drugs fast and get serial blood sample with a single invasiveprocedure emergency departments. Accidentally, the venous catheters may be introducedinto arteries ending up with pulseless hands. Following up pink pulsenesshands is an important concept to rescue the extremity. The presented case is a3-days old infant with no trauma history to the upper extremities but showing upwith bilateral, pink, pulseless hand secondary to accidental arterial vascular injuryduring venous catheterization. Pink pulseness hand treatment is still controversial inthe literature. In pink pulseness hand cases where close monitoring can be applied,good results are obtained without surgical exploration.

PDF

___

Kuttner H, Baruch M. Der traumatische segmentare Gefasskrampf. Bruns Beitr. z. Klin Chir. 1920;120:1.
Montgomery AH, Ireland J. Traumatic segmentary arterial spasm. Journal of the American Medical Association. 1935;105(22):1741-6.
Mustard W, Simmons E. Experimental arterial spasm in the lower extremities produced by traction. Bone & Joint Journal. 1953;35(3):437-41.
Blakey C, Biant L, Birch R. Ischaemia and the pink, pulseless hand complicating supracondylar fractures of the humerus in childhood. Bone & Joint Journal. 2009;91(11):1487- 92.
Malviya A, Simmons D, Vallamshetla R, Bache CE. Pink pulseless hand following supra- condylar fractures: an audit of British practice. Journal of Pediatric Orthopaedics B. 2006;15(1):62-4.
Mangat K, Martin A, Bache C. The ‘pulseless pink’hand after supracondylar fracture of the humerus in children. Bone & Joint Journal. 2009;91(11):1521-5.
Griffin K, Walsh S, Markar S, Tang T, Boyle J, Hayes P. The pink pulseless hand: a review of the literature regarding management of vascular complications of supracondylar humeral fractures in children. European Journal of Vascular and Endovascular Surgery. 2008;36(6):697-702.
Louahem D, Cottalorda J. Acute ischemia and pink pulseless hand in 68 of 404 gartland type III supracondylar humeral fractures in children: Urgent management and therapeutic consensus. Injury. 2016;47(4):848-52.
Özkul E, Gem M, Alemdar C. et al. Vascular Injury Following Supracondylar Humerus Fractures in Children. Ulus Travma Acil Cerrahi Derg. 2016;22(1):84-9.
Arquilla B, Gupta R, Gernshiemer J, Fischer M. Acute arterial spasm in an extremity caused by inadvertent intra-arterial injection successfully treated in the emergency department. The Journal of emergency medicine. 2000;19(2):139-43.