From the Research
Nitroglycerin is effective for treating post-vasopressor induced tissue necrosis, as evidenced by a case series where intravenous nitroglycerin improved postvasopressor digital ischemia for comfort care measures 1. The recommended application is a thin layer of 2% topical ointment to the affected tissue, covered with a non-adherent dressing, applied 2-4 times daily.
- Treatment duration varies based on clinical response but often continues for 1-2 weeks or until tissue perfusion improves.
- Nitroglycerin works by causing local vasodilation through nitric oxide release, which improves blood flow to ischemic tissues damaged by vasopressors.
- This helps reverse vasoconstriction, increases tissue perfusion, and promotes healing of necrotic areas. When implementing this treatment, monitor for systemic absorption that could cause hypotension, especially in patients with cardiovascular instability, as noted in various studies 2, 3, 4, 5.
- Headaches are a common side effect. The treatment should be part of a comprehensive approach that includes:
- Wound care
- Debridement of necrotic tissue if necessary
- Addressing the underlying condition that required vasopressor support initially It is essential to prioritize the patient's comfort and quality of life, as well as the family's needs, during the treatment process, as highlighted in the case series 1.