Prevention and therapy of leg ischaemia in extracorporeal life support and extracorporeal membrane oxygenation with peripheral cannulation.

Prevention and therapy of leg ischaemia in extracorporeal life support and extracorporeal membrane oxygenation with peripheral cannulation. Swiss Med Wkly. 2016;146:w14304 Authors: von Segesser L, Marinakis S, Berdajs D, Ferrari E, Wilhelm M, Maisano F Abstract Extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS) have been around for a long time, but it is only in recent years, with the advent of acute respiratory distress syndrome consecutive to influenza A (H1N1) infection, that these life-saving technologies have seen a broader application. Although the results of ECLS and ECMO are perceived as generally encouraging, there are still disturbing complications related to peripheral cannulation in general and, more specifically, to cannulation in the groin. The present review was designed to assess the magnitude of this latter problem, i.e. leg ischaemia related to ECLS and ECMO, in the literature and to identify strategies for possible therapies and, more importantly, prevention. The search strategy selected identified seven original articles with more than twenty patients, totalling 407 patients who underwent veno-arterial ECMO, and one large review dealing with all kinds of complications. For the original reports, the number of cases with veno-arterial support ranged from 21 to 143, with, as far as available, frequency of ischaemic complications between 11% and 52%, a reported range of surgical interven...
Source: Swiss Medical Weekly - Category: Journals (General) Authors: Tags: Swiss Med Wkly Source Type: research