Botulinum Toxin A for Treatment of Catocholamine Induced Finger Necrosis

Botulinum Toxin for Treatment of Catocholamine Induced Finger Necrosis - a Double Blind Randomized Control Prospective Study.

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.

Inclusion Criteria:

• Patients treated with vasoactive drugs (amines) and have finger/toe necrosis

Exclusion Criteria:

• Sensitivity to drug (Botox) ingredients.
• Active local limb infection
• ICU admission due to botulism
• Chronic muscular weakness disease, e.g., Myasthenia gravis, ALS
• Age lower than 18