NeoNotes Journal Club
Andrew B. Kairalla MD, Editor
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Topical Nitroglycerin Ointment
The Use of Topical Nitroglycerin Ointment to Treat Peripheral Tissue Ischemia Secondary to Arterial Line Complications in Neonates. Baserga MC, Puri A, and Sola A. J. Perinatol (July/Aug 2002) 22:416-419.
Catheterization of the aorta through the umbilical artery and/or of peripheral arteries in neonates may be accompanied by a number of complications, of which thrombotic phenomena and peripheral vasospasm are the most common. Two neonates with peripheral ischemia caused by vasospasm from indwelling umbilical artery catheterization and one infant with left hand ischemia due to a left radial artery line were successfully treated with 2% nitroglycerin ointment. No adverse effects were noted.
Comment. Topical nitroglycerin ointment has previously been reported to effectively treat dopamine or TPN extravasations. We now see that it can be effective in improving ischemia secondary to indwelling arterial lines. It makes sense that it should work, and the pictures in the article are impressive. If you try it, keep a close eye on the baby’s blood pressure. ABK.
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