Risk factors for lower limb complications in the patients undergoing venoarterial extracorporeal membrane oxygenation by percutaneous cannulation
Yin Liyi
Hu Conglong
Xu Jing
Zhan Jin
Huang Mingjun
Cao Yan
Abstract：Objective To analyze the major risk factors of lower limb complications in the patients undergoing venoarterial extracorporeal membrane oxygenation(VA-ECMO)by percutaneous cannulation.Methods Clinical data were collected from 304 patients who underwent VA-ECMO treatment for circulatory failure at the First Affiliated Hospital of Zhengzhou University between January 2020 and December 2022.The patients were divided into two groups based on their clinical events:the lower limb complication group and the non-lower limb complication group.Comparative analysis of clinical data between the two groups was conducted,and Logistic multivariate analysis was used to identify the risk factors for lower limb complications.Results A total of 209 patients met the inclusion criteria for this retrospective study.The incidence of lower limb complications was 27.8％(n=58).There were significantly statistical differences in intra-aortic balloon pump(IABP)treatment,mechanical ventilation,lactic acid levels at 4 h and 24 h after ECMO initiation,24 h ECMO flow,ECMO operation complications,neurological complications,hyperbilirubinemia,acute kidney injury requiring continuous renal replacement therapy(CRRT),infection complications and mortality between the non-lower limb complication group and the lower limb complication group(P＜0.05).Logistic multivariate regression analysis identified IABP treatment and lactate levels at 24 h after ECMO as independent risk factors for lower limb complications in the patients with VA-ECMO.Generalized additive models(GAM)analysis demonstrated a positive correlation between lactate levels at 24 h after ECMO and the incidence of lower limb complications.Conclusions IABP treatment and lactate levels at 24 h after ECMO are independent risk factors for lower limb complications in VA-ECMO patients.These factors should be closely monitored during VA-ECMO treatment to enable early prevention and intervention of lower limb complications.
Keywords：Extracorporeal membrane oxygenationLower limb complicationsRisk factorsIntra-aortic balloon pumpLactic acidContinuous renal replacement therapy
Publication Date：2024-11-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 955-959 )