Iatrogenic Arterial Injuries in Neonates Secondary To Venepuncture Presentation Management and Outcome

• Main Authors: Rashid Usman, Muhammad Jamil, Khalid Mehmood
• Format: Article
• Language: English
• Published: Dow University of Health Sciences 2017-08-01
• Series: Journal of the Dow University of Health Sciences
• Subjects: arterial; iatrogenic; injury; neonates; venepuncture
• Online Access: http://www.jduhs.com/index.php/jduhs/article/view/503

Objective: To share collective operative experience in management of iatrogenic arterial injuries secondary to venepuncture in terms of demographics, clinical presentation, treatment and outcome; along with review of current relevant literature. Materials & Methods: A prospective review of database at tertiary care military hospitals of all iatrogenic paediatric arterial injuries from March 2006 to March 2016 was performed. The data was analysed in terms of demographics, presentation, treatment and outcome. Results: A total of 28 patients were referred from various hospitals with iatrogenic arterial injuries during venepuncture. The mean age was 13± SD 4 days and weight was 2.6± SD 0.8 Kgs. Of the 28; 71.4% (n=20) had acute limb ischemia (ALI), 21.4% (n=6) dry gangrene and 7.1% (n=2) had pseudo-aneurysm. All patients with ALI underwent thrombo-embolectomy, amputations were done for dry gangrene and pseudo-aneurysms were resected with reverse venous bypass grafting. Mean follow up of 12 months was uneventful. Conclusion: Iatrogenic neonatal arterial injuries secondary to venepuncture are rare but may cause limb and even life threatening complications. Early diagnosis and surgical intervention using microsurgical techniques is limb saving and prevents long term complications.