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10.1016/j.ijscr.2015.07.012 http://scihub22266oqcxt.onion/10.1016/j.ijscr.2015.07.012 C4573421!4573421 !26232740     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=26232740 &cmd=llinks): Failed to open stream: HTTP request failed! 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Four limb amputations due to peripheral gangrene from inotrope use - Case report and review of the literature |pdf=|usr=}}{{26232740 }} gab.com Text Four limb amputations due to peripheral gangrene from inotrope use - Case report and review of the literature JO: Int J Surg Case Rep http://www.kidney.de/pget.php?&tw=1&pmid=26232740 #FOAvip INTRODUCTION: We present a rare case of 4 limb amputations due to peripheral gangrene which resulted from the use of inotropes for septic shock. PRESENTATION OF CASE: A 72-year-old woman with no past medical history presented with fever and pain in bilateral big toes. She was diagnosed with Streptococcal pneumoniae septicaemia and was started on broad spectrum antibiotics, dopamine and noradrenaline in the medical intensive care unit. She developed peripheral gangrene of all 4 extremities due to microvascular spasm from inotrope use and 4 limb amputations were performed electively in a single stage. DISCUSSION: The gangrene was contributed by the presence of disseminated intravascular coagulation and septic shock. There was no evidence of an autoimmune disorder or vasculitis on laboratory investigations and tissue histology. CONCLUSION: Microvascular spasm is a rare complication of inotrope use which may lead to extensive peripheral gangrene. Anecdotal reports of reversal agents have been discussed. Four limb amputations are a reasonable option especially if done in an elective setting after the gangrene has demarcated itself. Rehabilitation with prosthesis after 4 limb amputations can result in good functional outcome. Twit Text FOAVip Four limb amputations due to peripheral gangrene from inotrope use - Case report and review of the literature ????Int J Surg Case Rep http://www.kidney.de/pget.php?&tw=1&pmid=26232740 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=26232740 #FOAvip English Wikipedia <ref>{{Cite pmid|26232740 }}</ref> Four limb amputations due to peripheral gangrene from inotrope use - Case report and review of the literature #MMPMID26232740 Ang CH ; Koo OT ; Howe TS Int J Surg Case Rep 2015[]; 14 (ä): 63-5 PMID26232740 show ga INTRODUCTION: We present a rare case of 4 limb amputations due to peripheral gangrene which resulted from the use of inotropes for septic shock. PRESENTATION OF CASE: A 72-year-old woman with no past medical history presented with fever and pain in bilateral big toes. She was diagnosed with Streptococcal pneumoniae septicaemia and was started on broad spectrum antibiotics, dopamine and noradrenaline in the medical intensive care unit. She developed peripheral gangrene of all 4 extremities due to microvascular spasm from inotrope use and 4 limb amputations were performed electively in a single stage. DISCUSSION: The gangrene was contributed by the presence of disseminated intravascular coagulation and septic shock. There was no evidence of an autoimmune disorder or vasculitis on laboratory investigations and tissue histology. CONCLUSION: Microvascular spasm is a rare complication of inotrope use which may lead to extensive peripheral gangrene. Anecdotal reports of reversal agents have been discussed. Four limb amputations are a reasonable option especially if done in an elective setting after the gangrene has demarcated itself. Rehabilitation with prosthesis after 4 limb amputations can result in good functional outcome. äFour limb amputations due to peripheral gangrene from inotrope use - C(epmc).pdf DeepDyve Pubget Overpricing