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Arterial cannulation facilitates frequent blood sampling and blood pressure monitoring in sick neonates who need intensive care. However, accidental arterial cannulation while achieving peripheral venous access is not rare. Ischaemia following non-heparinized intravenous fluid intended for venous infusion, eventually resulting in irreversible tissue necrosis, gangrene and loss of tissue is reported. Preterm neonates are more susceptible to catheter related adverse effects like vasospasm, thromboembolism and peripheral ischaemia due to their small arterial diameter and inherent immaturity of haemostasis.

Topical nitroglycerine in management of peripheral ischaemia in a neonate following arterial cannulation