Progressive Protocols for Pediatric Acute Lower Extremity Ischemia Postcatheterization Pediatric Lower Extremity Ischemia Protocol Postcatheterization.

BACKGROUND: Pediatric acute lower extremity ischemia postcatheterization (PALIC) represents a significant clinical challenge. Effective management protocols that minimize aggressive interventions and complications are essential for improving patient outcomes. This investigation assesses the effectiveness of the FAST protocol (Fasudil infusion combined with Anticoagulation based on oxygen Saturation monitoring backup with Thrombolytic) series in treating pediatric acute lower extremity ischemia after catheterization (PALIC), with a particular emphasis on minimizing aggressive interventions and complications.

METHODS: A retrospective study of 1,380 pediatric catheterization cases from January 2009 to December 2022 was conducted. The research encompassed 3 stages: before FAST implementation (stage 1), during initial FAST adoption (stage 2), and subsequent FAST+ upgrade (stage 3).

RESULTS: Acute lower extremity ischemia (ALI) was observed in 7.1% (98/1,380) of pediatric cases postcatheterization. The PALIC detection rates in stages 2 and 3 were 4.2% and 12.1%, respectively, showing a statistically significant reduction in aggressive interventions from 100% to 0% and complications from 100% to 1.2% in later stages (P < 0.05).

CONCLUSION: The safety and effectiveness of both the FAST and FAST+ protocols in managing PALIC have been demonstrated. The enhanced FAST+ protocol notably improve early detection, thereby augmenting the effectiveness of treatment.