Prevention and management strategy of lower extremity complications after extracorporeal membrane oxygenation via femoral artery and vein
Guo Jian
Lu Andong
Miao Lixia
Min Kai
Abstract：Objective To summarize the prevention and management strategy of lower extremity ischemia and thrombotic complications during femoral arteriovenous extracorporeal membrane oxygenation (ECMO). Methods Clinical data of 22 patients with ECMO (V-A mode) assisted treatment for circulatory failure from May 2014 to March 2018 were analyzed retrospectively. The distal end of lower extremity perfusion and complications of those patients were also analyzed. Results Of the 22 patients, 13 cases were successfully weaned from ECMO (59.1％). During 2014 and 2016, a distal perfusion cannula was routinely placed through superficial femoral artery (17 cases); from 2017 to present, distal perfusion cannulation was not routinely placed, and the placement was decided according to the clinical situation and lower extremity ultrasound blood flow (Of five cases, three were not cannulated whereas two were cannulated thereafter). Among them, three patients suffered from lower extremity swelling. There were two cases of macula, which improved after the distal perfusion tube was placed under the guidance of ultrasound, and no lower limb ischemia or necrosis occurred.Conclusion ECMO plays an important role in the treatment of acute circulatory failure. Lower extremity complications have great impacts on the prognosis. According to the conditions of patients, rational placement of distal perfusion, anticoagulant and distal flow management are needed to reduce the rate of disability and to improve the success rate of ECMO and the life quality of patients.
Keywords：Extracorporeal membrane oxygenationLower extremity complicationDistal perfusionIschemiaVenous thrombosis
Publication Date：2019-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 22-25 )