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

Rashid Usman, Muhammad Jamil, Khalid Mehmood

Abstract


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.

Keywords


Arterial, iatrogenic, injury, neonates, venepuncture.

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