Distal Perfusion Cannulation and Limb Complications in Venoarterial Extracorporeal Membrane Oxygenation.

Distal Perfusion Cannulation and Limb Complications in Venoarterial Extracorporeal Membrane Oxygenation.
J Extra Corpor Technol. 2018 Sep;50(3):155-160
Authors: Elmously A, Bobka T, Khin S, Afzal A, de Biasi AR, DeBois WJ, Guy TS, D'ayala M, Gulkarov I, Salemi A, Worku B
Abstract
The utility of distal perfusion cannula (DPC) placement for the prevention of limb complications in patients undergoing femoral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) is poorly characterized. Patients undergoing femoral VA ECMO cannulation at two institutions were retrospectively assessed. Patients were grouped into those who did and those who did not receive a DPC at the time of primary cannulation. The primary outcome was any limb complication. Secondary outcomes included successfully weaning ECMO and in-hospital mortality. A total of 75 patients underwent femoral cannulation between December 2010 and December 2017. Of those, 65 patients (86.7%) had a DPC placed during primary cannulation and 10 patients (13.3%) did not. Baseline demographics, indications for ECMO, and hemodynamic perturbations were well matched between groups. The rate of limb complications was 14.7% (11/75) for the overall cohort and did not differ between groups (p = .6). Three patients (4%) required a four-compartment fasciotomy for compartment syndrome in the DPC group; no patients without a DPC required fasciotomy. Of the three patients who required a thrombecto...

Source: Journal of Extra-Corporeal Technology - September 28, 2018 Category: Cardiovascular & Thoracic Surgery Tags: J Extra Corpor Technol Source Type: research