Use of Topical Nitroglycerin in the Treatment of Acute Limb Ischemia: Four-Year Experience in a Mixed Neonatal and Pediatric Intensive Care Unit

TL;DR

Topical nitroglycerin may be a safe and effective treatment for acute limb ischemia in children, with partial or complete recovery observed in most cases.

Contribution

The study provides a four-year clinical experience on the use of topical nitroglycerin for pediatric acute limb ischemia in an ICU setting.

Findings

Six out of seven children showed at least partial recovery after treatment with topical nitroglycerin.

Three children achieved complete recovery, while three underwent amputation.

No adverse side effects were recorded during the treatment period.

Abstract

Pediatric Acute Limb Ischemia (ALI) is a rare condition, sometimes encountered in the Intensive Care Unit (ICU). Optimal treatment remains to be established. Topical nitroglycerin has been suggested as a vasodilator agent, used to improve limb reperfusion.

We performed a retrospective descriptive study, with data from a PICU of a tertiary hospital, from 2021 to 2024.

Seven children presented with ALI treated with topical nitroglycerin, with a median age of 244 days. Wrongful arterial catheterization was established as the cause of ALI in four out of seven children. Six out of seven children showed at least partial recovery. Complete recovery was achieved in three children. Three children underwent partial or total amputation. No adverse side effects were recorded.

Topical nitroglycerin appears to be a beneficial and safe intervention in children with ALI.

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