CASE REPORTSNorepinephrine-Induced Peripheral Ischemia Leading to Gangrene: A Case SeriesWilson, Michael BS; Schafer, Kristin MD; Goldschmidt, Eric MD; Wu, Benita BS; Simman, Richard MD, FACS, FACCWSAuthor Information Michael Wilson, BS, is Medical Student, Wright State University, Boonshoft School of Medicine, Dayton, Ohio. Kristin Schafer, MD, and Eric Goldschmidt, MD, are Medical Residents, University of Toledo Medical Center, Toledo, Ohio. Benita Wu, BS, is Medical Student, Wright State University, Boonshoft School of Medicine. Richard Simman, MD, FACS, FACCWS, is Plastic and Reconstructive Surgeon, Jobst Vascular Institute, Toledo. Acknowledgments: The authors thank Dr Jeffrey Travers for his contributions to this project. This study was presented as a poster titled “Wounds Resulting From Local and Systemic Effects of Vasopressors: A Case Series” at the Symposium for Advanced Wound Care Fall, November 2018, in Las Vegas, NV. The authors have disclosed no financial relationships related to this article. Submitted October 30, 2019; accepted in revised form August 10, 2020. Advances in Skin & Wound Care: May 2021 - Volume 34 - Issue 5 - p 273-277 doi: 10.1097/01.ASW.0000741528.49437.2c Buy Metrics Abstract Norepinephrine is used in the acute care setting to establish and maintain hemodynamic stability in patients with hypotension. Although it is often a lifesaving medication, norepinephrine may lead to profound vascular insufficiency in the extremities, resulting in dry gangrene and skin necrosis. The purpose of this article is to present a case series of skin complications related to treatment with norepinephrine and review the pathophysiology behind these complications. The authors also explore risk stratification as it relates to history and clinical presentation with subsequent focus on contingencies to mitigate the adverse effects of vasoconstriction on peripheral tissues. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.