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To the Editor:—
A report by Dippy and Dorney, in The Journal, Aug. 1, page 1647, presents an instance of tissue necrosis after infusion of a dilute solution of metaraminol (Aramine). The drug had been added to a solution of 5% dextrose in water and was infused into the saphenous vein at ankle level. The patient's extremity was pulseless due to previous thrombotic occlusion of the terminal aorta. The danger of ischemic necrosis after intravenous infusions of dextrose, saline solution, or blood into a superficial vein in the ankle has been described (Anning: Lancet2:1126 [Nov. 27] 1954; Banerji: Lancet1:514 [March 5] 1955; and Fisher and Bard: New York J. Med.57:3180 [Oct. 1] 1957; McNair and Dudley, Lancet2:365 [Sept. 19] 1959). Ulceration after infusion of these fluids occurred in normally vascularized lower extremities. The added risk in patients with severe arterial insufficiency is
Weil MH. TISSUE NECROSIS. JAMA. 1959;171(13):1868. doi:10.1001/jama.1959.03010310100026
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