Differentiation of Lower Extremity Skin Changes in the Intensive Care Setting

Abstract

Digital and lower extremity skin changes often signify critical underlying disorders. Patients in the intensive care unit also frequently have hemodynamic instability requiring the use of vasoactive medications, which may lead to various presentations of limb ischemia; preexisting conditions increase these patients’ risk for arterial embolization. Most arterial emboli are clots that originate in the heart and travel to distant vascular beds, where they cause arterial occlusion, ischemia, and, potentially, infarction; the 2 most common sequelae are stroke and lower limb ischemia. Emboli also arise from atherosclerotic plaques. Other conditions can also cause skin color changes in this vulnerable population. Prompt recognition and differentiation of lower extremity skin changes can result in improved patient outcomes. A thorough literature search was conducted to differentiate the primary causes of lower extremity and digital skin changes in the critically ill patient and outline diagnostic and management techniques.

Multidisciplinary approach in the treatment of patients with diabetic foot syndrome. Experience of Almazov National Medical Research Centrе

“…Клинические исследования показывают, что облитерирующий атеросклероз развивается у 50 % пациентов с диабетом 2 типа в течение 15 лет после начала заболевания. Артериосклероз у пациентов с диабетом и без него гистологически очень похож [16]. Клинически важным отличием является анатомическое распределение болезни.…”