Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report
Purpose This case report describes the use of ultrasound-guided stellate ganglion blockade to treat sepsis-related digital ischemia in the intensive care unit (ICU). Clinical features A 71-yr-old female was admitted to the ICU with septic shock and acute respiratory distress syndrome (ARDS) followin...
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| Veröffentlicht in: | Canadian journal of anesthesia 2016-01, Vol.63 (1), p.56-60 |
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| container_title | Canadian journal of anesthesia |
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| creator | Bataille, Benoît Nucci, Bastian Mora, Michel Silva, Stein Cocquet, Pierre |
| description | Purpose
This case report describes the use of ultrasound-guided stellate ganglion blockade to treat sepsis-related digital ischemia in the intensive care unit (ICU).
Clinical features
A 71-yr-old female was admitted to the ICU with septic shock and acute respiratory distress syndrome (ARDS) following an initial right hemicolectomy complicated by an anastomotic leak and peritonitis. The patient’s condition was further complicated by an abdominal abscess 22 days later. She had type-2 diabetes mellitus and hypertension but no history of vascular disease. With continuing sepsis from the abscess and requiring mechanical ventilation due to ARDS, she developed upper limb digital ischemia refractory to treatment with a low dose of dobutamine and isosorbide dinitrate. We subsequently performed ultrasound-guided bilateral stellate ganglion blockade with the intent of restoring perfusion to her fingers before digital necrosis developed. One hour after each stellate ganglion block, the symptoms of digital ischemia completely resolved. The benefit persisted for two days, and then a repeat block was performed with similar results.
Conclusions
This case illustrates the potential advantages of ultrasound-guided stellate ganglion blockade for the treatment of sepsis-related digital ischemia refractory to standard therapy. |
| doi_str_mv | 10.1007/s12630-015-0503-z |
| format | Article |
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This case report describes the use of ultrasound-guided stellate ganglion blockade to treat sepsis-related digital ischemia in the intensive care unit (ICU).
Clinical features
A 71-yr-old female was admitted to the ICU with septic shock and acute respiratory distress syndrome (ARDS) following an initial right hemicolectomy complicated by an anastomotic leak and peritonitis. The patient’s condition was further complicated by an abdominal abscess 22 days later. She had type-2 diabetes mellitus and hypertension but no history of vascular disease. With continuing sepsis from the abscess and requiring mechanical ventilation due to ARDS, she developed upper limb digital ischemia refractory to treatment with a low dose of dobutamine and isosorbide dinitrate. We subsequently performed ultrasound-guided bilateral stellate ganglion blockade with the intent of restoring perfusion to her fingers before digital necrosis developed. One hour after each stellate ganglion block, the symptoms of digital ischemia completely resolved. The benefit persisted for two days, and then a repeat block was performed with similar results.
Conclusions
This case illustrates the potential advantages of ultrasound-guided stellate ganglion blockade for the treatment of sepsis-related digital ischemia refractory to standard therapy.</description><identifier>ISSN: 0832-610X</identifier><identifier>EISSN: 1496-8975</identifier><identifier>DOI: 10.1007/s12630-015-0503-z</identifier><identifier>PMID: 26415545</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abscesses ; Aged ; Anesthesiology ; Autonomic Nerve Block - methods ; Cardiology ; Case reports ; Case Reports/Case Series ; Critical Care Medicine ; Diabetes ; Female ; Humans ; Hypertension ; Intensive ; Intensive care ; Ischemia ; Ischemia - therapy ; Medicine ; Medicine & Public Health ; Pain Medicine ; Patients ; Pediatrics ; Peritonitis ; Pneumology/Respiratory System ; Respiratory distress syndrome ; Sepsis ; Stellate Ganglion - diagnostic imaging ; Surgical anastomosis ; Ultrasonic imaging ; Ultrasonography, Interventional ; Upper Extremity - blood supply ; Ventilators</subject><ispartof>Canadian journal of anesthesia, 2016-01, Vol.63 (1), p.56-60</ispartof><rights>Canadian Anesthesiologists' Society 2015</rights><rights>Canadian Anesthesiologists' Society 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-186fda030cb60d9dde3a74fdba2ff49f8f3e00540576e93be7bc899ee6b66b563</citedby><cites>FETCH-LOGICAL-c485t-186fda030cb60d9dde3a74fdba2ff49f8f3e00540576e93be7bc899ee6b66b563</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12630-015-0503-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12630-015-0503-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26415545$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bataille, Benoît</creatorcontrib><creatorcontrib>Nucci, Bastian</creatorcontrib><creatorcontrib>Mora, Michel</creatorcontrib><creatorcontrib>Silva, Stein</creatorcontrib><creatorcontrib>Cocquet, Pierre</creatorcontrib><title>Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report</title><title>Canadian journal of anesthesia</title><addtitle>Can J Anesth/J Can Anesth</addtitle><addtitle>Can J Anaesth</addtitle><description>Purpose
This case report describes the use of ultrasound-guided stellate ganglion blockade to treat sepsis-related digital ischemia in the intensive care unit (ICU).
Clinical features
A 71-yr-old female was admitted to the ICU with septic shock and acute respiratory distress syndrome (ARDS) following an initial right hemicolectomy complicated by an anastomotic leak and peritonitis. The patient’s condition was further complicated by an abdominal abscess 22 days later. She had type-2 diabetes mellitus and hypertension but no history of vascular disease. With continuing sepsis from the abscess and requiring mechanical ventilation due to ARDS, she developed upper limb digital ischemia refractory to treatment with a low dose of dobutamine and isosorbide dinitrate. We subsequently performed ultrasound-guided bilateral stellate ganglion blockade with the intent of restoring perfusion to her fingers before digital necrosis developed. One hour after each stellate ganglion block, the symptoms of digital ischemia completely resolved. The benefit persisted for two days, and then a repeat block was performed with similar results.
Conclusions
This case illustrates the potential advantages of ultrasound-guided stellate ganglion blockade for the treatment of sepsis-related digital ischemia refractory to standard therapy.</description><subject>Abscesses</subject><subject>Aged</subject><subject>Anesthesiology</subject><subject>Autonomic Nerve Block - methods</subject><subject>Cardiology</subject><subject>Case reports</subject><subject>Case Reports/Case Series</subject><subject>Critical Care Medicine</subject><subject>Diabetes</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Ischemia</subject><subject>Ischemia - therapy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pain Medicine</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Peritonitis</subject><subject>Pneumology/Respiratory System</subject><subject>Respiratory distress syndrome</subject><subject>Sepsis</subject><subject>Stellate Ganglion - diagnostic imaging</subject><subject>Surgical anastomosis</subject><subject>Ultrasonic imaging</subject><subject>Ultrasonography, Interventional</subject><subject>Upper Extremity - blood supply</subject><subject>Ventilators</subject><issn>0832-610X</issn><issn>1496-8975</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1rFTEUhoMo9lr9AW4k4MbN2JNkksm4k-IXFNxYcBeSyZlp6tzJmGTQ9tc3l1tFCq5ySJ7z5hweQl4yeMsAurPMuBLQAJMNSBDN7SOyY22vGt138jHZgRa8UQy-n5BnOV8DgFZSPyUnXLVMylbuyO_LuSSb47b4ZtqCR09dmG3BZGeaC86Hmk52meYQF-rmOPywHmmJtCS0hfowhVLZkIcr3AdLw0ItXW0JuBT6K5QrmnHNIb-r14PNSBOuMZXn5Mlo54wv7s9Tcvnxw7fzz83F109fzt9fNEOrZWmYVqO3IGBwCnzvPQrbtaN3lo9j2496FAggW5Cdwl447Nyg-x5ROaWcVOKUvDnmrin-3DAXs6-jHvZaMG7ZsE5LzjjveEVfP0Cv45aWOl2lpGiFgo5Vih2pIcWcE45mTWFv041hYA5azFGLqVrMQYu5rT2v7pM3t0f_t-OPhwrwI5Dr0zJh-ufr_6beAX-fmkM</recordid><startdate>20160101</startdate><enddate>20160101</enddate><creator>Bataille, Benoît</creator><creator>Nucci, Bastian</creator><creator>Mora, Michel</creator><creator>Silva, Stein</creator><creator>Cocquet, Pierre</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160101</creationdate><title>Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report</title><author>Bataille, Benoît ; Nucci, Bastian ; Mora, Michel ; Silva, Stein ; Cocquet, Pierre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-186fda030cb60d9dde3a74fdba2ff49f8f3e00540576e93be7bc899ee6b66b563</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abscesses</topic><topic>Aged</topic><topic>Anesthesiology</topic><topic>Autonomic Nerve Block - methods</topic><topic>Cardiology</topic><topic>Case reports</topic><topic>Case Reports/Case Series</topic><topic>Critical Care Medicine</topic><topic>Diabetes</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Ischemia</topic><topic>Ischemia - therapy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pain Medicine</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Peritonitis</topic><topic>Pneumology/Respiratory System</topic><topic>Respiratory distress syndrome</topic><topic>Sepsis</topic><topic>Stellate Ganglion - diagnostic imaging</topic><topic>Surgical anastomosis</topic><topic>Ultrasonic imaging</topic><topic>Ultrasonography, Interventional</topic><topic>Upper Extremity - blood supply</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bataille, Benoît</creatorcontrib><creatorcontrib>Nucci, Bastian</creatorcontrib><creatorcontrib>Mora, Michel</creatorcontrib><creatorcontrib>Silva, Stein</creatorcontrib><creatorcontrib>Cocquet, Pierre</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business & Current Affairs Database</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Canadian journal of anesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bataille, Benoît</au><au>Nucci, Bastian</au><au>Mora, Michel</au><au>Silva, Stein</au><au>Cocquet, Pierre</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report</atitle><jtitle>Canadian journal of anesthesia</jtitle><stitle>Can J Anesth/J Can Anesth</stitle><addtitle>Can J Anaesth</addtitle><date>2016-01-01</date><risdate>2016</risdate><volume>63</volume><issue>1</issue><spage>56</spage><epage>60</epage><pages>56-60</pages><issn>0832-610X</issn><eissn>1496-8975</eissn><abstract>Purpose
This case report describes the use of ultrasound-guided stellate ganglion blockade to treat sepsis-related digital ischemia in the intensive care unit (ICU).
Clinical features
A 71-yr-old female was admitted to the ICU with septic shock and acute respiratory distress syndrome (ARDS) following an initial right hemicolectomy complicated by an anastomotic leak and peritonitis. The patient’s condition was further complicated by an abdominal abscess 22 days later. She had type-2 diabetes mellitus and hypertension but no history of vascular disease. With continuing sepsis from the abscess and requiring mechanical ventilation due to ARDS, she developed upper limb digital ischemia refractory to treatment with a low dose of dobutamine and isosorbide dinitrate. We subsequently performed ultrasound-guided bilateral stellate ganglion blockade with the intent of restoring perfusion to her fingers before digital necrosis developed. One hour after each stellate ganglion block, the symptoms of digital ischemia completely resolved. The benefit persisted for two days, and then a repeat block was performed with similar results.
Conclusions
This case illustrates the potential advantages of ultrasound-guided stellate ganglion blockade for the treatment of sepsis-related digital ischemia refractory to standard therapy.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26415545</pmid><doi>10.1007/s12630-015-0503-z</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Canadian journal of anesthesia, 2016-01, Vol.63 (1), p.56-60 |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abscesses Aged Anesthesiology Autonomic Nerve Block - methods Cardiology Case reports Case Reports/Case Series Critical Care Medicine Diabetes Female Humans Hypertension Intensive Intensive care Ischemia Ischemia - therapy Medicine Medicine & Public Health Pain Medicine Patients Pediatrics Peritonitis Pneumology/Respiratory System Respiratory distress syndrome Sepsis Stellate Ganglion - diagnostic imaging Surgical anastomosis Ultrasonic imaging Ultrasonography, Interventional Upper Extremity - blood supply Ventilators |
| title | Ultrasound-guided bilateral stellate ganglion blockade to treat digital ischemia in a patient with sepsis: a case report |
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