HIGH-DOSE ADRENALINE WITH LOW SYSTEMIC VASCULAR-RESISTANCE AND SYMMETRICAL PERIPHERAL GANGRENE

Symmetrical peripheral gangrene (SPG) is an uncommon syndrome consisti ng of distal ischaemic damage in two or more extremities, without larg e-vessel obstruction. We describe its development in the presence of a high cardiac and low systemic vascular resistance in a patient who wa s on high-dose adrenaline. With palpable radial and popliteal pulses t he patient's hands and feet became dusky. This progressed to SPG. A su dden increase in serum lactate to high levels, noted in this case, may mark the onset of SPG.