DOI QR코드

DOI QR Code

Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition

  • Park, Huee Jin (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Kim, Kyung Hoon (Department of Pediatrics, Seoul National University College of Medicine) ;
  • Lee, Hyuk Jin (Department of Orthopedic Surgery, Seoul National University College of Medicine) ;
  • Jeong, Eui Cheol (Department of Plastic Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Kim, Kee Won (Department of Rehabilitation Medicine, Seoul National University College of Medicine) ;
  • Suh, Dong In (Department of Pediatrics, Seoul National University College of Medicine)
  • 투고 : 2013.10.25
  • 심사 : 2014.05.16
  • 발행 : 2015.11.15

초록

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

키워드

참고문헌

  1. Elliott KG, Johnstone AJ. Diagnosing acute compartment syndrome. J Bone Joint Surg Br 2003;85:625-32.
  2. Hannon MG, Lee SK. Extravasation injuries. J Hand Surg Am 2011;36:2060-5. https://doi.org/10.1016/j.jhsa.2011.10.001
  3. Sung CY, Chung RK, Ra YS, Lee HS, Lee GY. Impending compartment syndrome of the forearm and hand after a pressurized infusion in a patient under general anesthesia: a case report. Korean J Anesthesiol 2011;60:60-3. https://doi.org/10.4097/kjae.2011.60.1.60
  4. Knobel RB, Meetze W, Cummings J. Case report: total parenteral nutrition extravasation associated with spinal cord compression and necrosis. J Perinatol 2001;21:68-71. https://doi.org/10.1038/sj.jp.7200473
  5. Restieaux M, Maw A, Broadbent R, Jackson P, Barker D, Wheeler B. Neonatal extravasation injury: prevention and management in Australia and New Zealand-a survey of current practice. BMC Pediatr 2013;13:34. https://doi.org/10.1186/1471-2431-13-34
  6. Shepherd R, Ong TH. Evaluation of percutaneously inserted peripheral silicone catheters for parenteral nutrition in infants and children. Aust Paediatr J 1980;16:181-4.
  7. Matsen FA 3rd, Krugmire RB Jr. Compartmental syndromes. Surg Gynecol Obstet 1978;147:943-9.
  8. Kumar RJ, Pegg SP, Kimble RM. Management of extravasation injuries. ANZ J Surg 2001;71:285-9. https://doi.org/10.1046/j.1440-1622.2001.02104.x
  9. Hee HI, Lim SL, Tan SS. Infusion technology: a cause for alarm. Paediatr Anaesth 2002;12:780-5. https://doi.org/10.1046/j.1460-9592.2002.00993.x
  10. Talbot SG, Rogers GF. Pediatric compartment syndrome caused by intravenous infiltration. Ann Plast Surg 2011;67:531-3. https://doi.org/10.1097/SAP.0b013e3182085915

피인용 문헌

  1. Treatment of extravasation injuries in infants and young children: a scoping review and survey vol.22, pp.46, 2015, https://doi.org/10.3310/hta22460
  2. Iatrogenic Dermatoses in Hospitalized Patients vol.7, pp.3, 2018, https://doi.org/10.1007/s13671-018-0227-8
  3. Measuring the Validity and Reliability of the Vascular Access Complication Staging and Treatment Instrument in a Pediatric Population vol.44, pp.4, 2021, https://doi.org/10.1097/nan.0000000000000431