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Evolution of distal limb perfusion management in adult peripheral venoarterial extracorporeal membrane oxygenation with femoral artery cannulation
J. Simons, B. Mees, G. MacLaren, JF. Fraser, AM. Zaaqoq, SM. Cho, BM. Patel, D. Brodie, J. Bělohlávek, M. Belliato, JS. Jung, L. Salazar, P. Meani, S. Mariani, M. Di Mauro, D. Yannopoulos, LM. Broman, YS. Chen, J. Riera, WN. van Mook, R. Lorusso
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, přehledy
- MeSH
- arteria femoralis * MeSH
- dospělí MeSH
- ischemie prevence a kontrola etiologie MeSH
- katetrizace metody MeSH
- končetiny krevní zásobení MeSH
- lidé MeSH
- mimotělní membránová oxygenace * metody MeSH
- perfuze metody MeSH
- periferní katetrizace metody škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal perfusion cannula to avoid or reduce limb ischaemia-related complications. Multiple alternative cannulation techniques to the distal perfusion cannula have been developed to maintain distal limb perfusion, including end-to-side grafting, external or endovascular femoro-femoral bypass, retrograde limb perfusion (e.g., via the posterior tibial, dorsalis pedis or anterior tibial artery), and, more recently, use of a bidirectional cannula. Venous congestion has also been recognized as a potential contributing factor to limb ischaemia development and specific techniques have been described with facilitated venous drainage or bilateral cannulation being the most recent, to reduce or avoid venous stasis as a contributor to impaired limb perfusion. Advances in monitoring techniques, such as near-infrared spectroscopy and duplex ultrasound analysis, have been applied to improve decision-making regarding both the monitoring and management of limb ischaemia. This narrative review describes the evolution of techniques used for distal limb perfusion during peripheral VA ECMO.
Cardiothoracic Intensive Care Unit National University Health System Singapore
Cardiovascular Research Institute Maastricht Maastricht University Maastricht The Netherlands
Center for Resuscitation Medicine University of Minnesota Medical School Minneapolis MN USA
Department of Anesthesiology Division of Critical Care University of Virginia Charlottesville VA USA
Department of Critical Care Mayo Clinic Arizona Scottsdale AZ USA
Department of Intensive Care Fundación Cardiovascular de Colombia Bucaramanga Colombia
Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden
Department of Surgery National Taiwan University Hospital Taipei Taiwan
Department of Thoracic and Cardiovascular Surgery Korea University Medicine Seoul Republic of Korea
S Gerardo Hospital is the hospital of the departmen Monza Italy
School of Health Professions Education Maastricht University Maastricht The Netherlands
Citace poskytuje Crossref.org
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- $a Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal perfusion cannula to avoid or reduce limb ischaemia-related complications. Multiple alternative cannulation techniques to the distal perfusion cannula have been developed to maintain distal limb perfusion, including end-to-side grafting, external or endovascular femoro-femoral bypass, retrograde limb perfusion (e.g., via the posterior tibial, dorsalis pedis or anterior tibial artery), and, more recently, use of a bidirectional cannula. Venous congestion has also been recognized as a potential contributing factor to limb ischaemia development and specific techniques have been described with facilitated venous drainage or bilateral cannulation being the most recent, to reduce or avoid venous stasis as a contributor to impaired limb perfusion. Advances in monitoring techniques, such as near-infrared spectroscopy and duplex ultrasound analysis, have been applied to improve decision-making regarding both the monitoring and management of limb ischaemia. This narrative review describes the evolution of techniques used for distal limb perfusion during peripheral VA ECMO.
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