Lunz, Dirk and Philipp, Alois and Mueller, Thomas and Pfister, Karin and Foltan, Maik and Rupprecht, Leopold and Schmid, Christof and Lubnow, Matthias and Graf, Bernhard and Sinner, Barbara (2019) Ischemia-related vascular complications of percutaneously initiated venoarterial extracorporeal membrane oxygenation: Indication setting, risk factors, manifestation and outcome. JOURNAL OF CRITICAL CARE, 52. pp. 58-62. ISSN 0883-9441, 1557-8615
Full text not available from this repository. (Request a copy)Abstract
Purpose: Venoarterial (VA) ECMO is widely accepted as salvage therapy for cardio-respiratory or cardiac failure. Vascular complications from cannulation are common and potentially life-threatening. Here, we retrospectively analyzed vascular complications following VA ECMO therapy. Material and methods: Patients treated with VA ECMO via femoral cannulation from 2010 to 2016 were enrolled. Patient factors, indication and procedure were retrieved from our hospital database and statistically analyzed. Results: 223 patients were enrolled. Survival rate was 43, 0%. Ischemic vascular complications were seen in 43, 9%. Main manifestation (82, 7%) was stenosis or occlusion of the femoral (common and superficial) or the external iliacal artery. Embolus or dissection occurred in 4, 1%. 32, 7% patients with ischemia required surgical intervention with 24,5% suffering from compartment syndrome. An antegrade perfusion catheter was established in 50% of the patients. Patients receiving VA ECMO for extracorporeal cardiopulmonary resuscitation had the lowest ischemic rates with 28,6%. Multiple regression analysis identified only the underlying indication and the size of the cannula as significant risk factor for vascular complications. Survival rates to hospital discharge were 37,3% and 47,2% in patients with and without ischemic complications. Conclusions: Cannula size and indication setting are the most important factors for the development of ischemic complications following VA ECMO. (C) 2019 Elsevier Inc. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LIMB ISCHEMIA; CANNULATION; SURVIVAL; VA ECMO; ECLS; Vascular complications; Ischemia; Risk factors; Indication setting |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Abteilung für Gefäßchirurgie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Apr 2020 06:30 |
| Last Modified: | 07 Apr 2020 06:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26585 |
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