Case Report

Topical Nitroglycerine for Neonatal Arterial Associated Peripheral Ischemia following Cannulation: A Case Report and Comprehensive Literature Review

Table 1

Literature review of neonates treated with nitroglycerin for arterial catheter-related ischemia and their outcomes.

Author/Year [Reference]Gestational age, wk; (Birth wt, g)Catheter typeRegion and clinical findings2% nitroglycerin topical doseOutcome

Wong et al./1992 [37]25; (700),
24; (780)
(1) Right radial
(2) Right radial
(1) No pulse, right hand blanched
(2) no pulse, blue fingers, right hand rigid
Ribbon 4 mm/kg in both cases(1) Improvement within 15 min, full recovery in 3 hr
(2) Two doses with complete recovery after 16 hr except for 2 small blue areas.

Varughese and Koh/2001 [38]33; (1870)UACIschemic changes over right hip.
Normal femoral + popliteal pulses
0.4 mg over 2 hr—twiceImprovement over 7 hr with complete resolution after 30 hr

Baserga et al./2002 [39](1) 30; (1620)
(2) 25; (not stated)
(3) 23; (660)
(1) UAC
(2) UAC
(3) Left radial
(1) Poor perfusion left leg, weak femoral + tibial pulses
(2) Right leg blanched, absent femoral pulse, cyanotic toes
(3) Pale left hand and fingers, absent radial pulse
(1) 4 single applications over affected parts-dose not stated
(2) 4 mm/kg—four single applications over affected parts
(3) ribbon of ointment-dose not stated-3 single applications to affected areas
(1) Complete recovery in 45 min
(2) Complete recovery in 45 min
(3) Improvement in 30 min with full recovery.

Vasquez et al./2003 [46]26; (896)Left peripheral arterial line (location not stated)Pale cyanotic left hand with discoloration from mid-palm to finger tips.Ribbon 4 mm/kg
q 8 hr for 27 days
Improvement in 8 hr with gradual recovery over 18–27 days. No deficit at 8 months.

UAC: umbilical arterial catheter.