Patients in the intensive care unit (ICU) often require blood pressure support of vasoactive drugs such as amines. Finger necrosis (so called "blue toe syndrome") is a well documented phenomena with incidence reaching as high as 60% in patients receiving vasopressin. Botulinum toxin is a known muscle relaxant used for a variety of medical application. Recently, several reports have demonstrated its effect in vasospastic disorders. It has also been in mice that when administered locally it has a local vasodilatory effect. The goal of this experiment is to compare the effect of Botulinum Toxin administered locally on amine induced finger necrosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
20
Injection of 200 units of Botulinum Toxin A (BOTOX) to a treated limb. Each limb will be divided to two levels - arterial arch and digital arteries (near MCP/MTP) levels. In each level 100 units of Botox will be injected in 6 injection points in the proximity of the arteries.
Injection of 0.5cc of normal saline (0.9% NaCl) to each injection site as in the Active drug arm.
Sheba Medical Center
Tel Litwinsky, Israel
RECRUITINGindex of Toe and Finger Ischemia (iTFI)
Score including: O2 peripheral saturation monitoring Bleeding Capillary refilling Limb temperature Limb discoloration
Time frame: three months after drug administration
Amputation
Amputations performed - fingers, toe and limb - height and number of amputations
Time frame: Three months after drug administration
Patients survival
Survival
Time frame: Three months after drug administration
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.