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Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation.

Publication ,  Journal Article
Ranney, DN; Benrashid, E; Meza, JM; Keenan, JE; Bonadonna, D; Mureebe, L; Cox, MW; Daneshmand, MA
Published in: ASAIO J
2018

Femoral arterial cannulation in adult venoarterial (VA) extracorporeal membrane oxygenation (ECMO) predisposes patients to ipsilateral limb ischemia. Placement of a distal perfusion catheter (DPC) is one of few techniques available to prevent or manage this complication. Although frequently used, the indications for and timing of DPC placement are poorly characterized, and no guidelines are available to guide its use. The purpose of this study was to compare the incidences of vascular complications and limb ischemia between patients who did and did not receive a DPC at the time of primary ECMO cannulation. Between June 2009 and April 2015, 132 adults underwent VA ECMO cannulation at our institution. Of the 80 femoral cannulations comprising this retrospective single-center study cohort, 14 (17.5%) received a DPC at the time of primary cannulation. Demographics, indications for ECMO, and cardiovascular history and risk factors were not significantly different between comparison groups. Median arterial cannula size was 17 French in both groups. Vascular complications occurred in 2 of the 14 patients with initial DPC (14.3%) compared with 21 of 66 without initial DPC (31.8%; p = 0.188). Limb ischemia occurred in 2 of 14 patients in the DPC group (14.3%) and 15 of 66 in the non-DPC group (22.7%; p = 0.483). In-hospital mortality was comparable between groups. DPC placement at the time of primary cannulation may lower the incidence of limb ischemia. The benefit of DPC placement once evidence of limb ischemia is apparent remains unclear.

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Published In

ASAIO J

DOI

EISSN

1538-943X

Publication Date

2018

Volume

64

Issue

3

Start / End Page

328 / 333

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • Risk Factors
  • Retrospective Studies
  • Perfusion
  • Middle Aged
  • Male
  • Leg
  • Ischemia
  • Incidence
  • Humans
 

Citation

APA
Chicago
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Ranney, D. N., Benrashid, E., Meza, J. M., Keenan, J. E., Bonadonna, D., Mureebe, L., … Daneshmand, M. A. (2018). Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation. ASAIO J, 64(3), 328–333. https://doi.org/10.1097/MAT.0000000000000656
Ranney, David N., Ehsan Benrashid, James M. Meza, Jeffrey E. Keenan, Desiree Bonadonna, Leila Mureebe, Mitchell W. Cox, and Mani A. Daneshmand. “Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation.ASAIO J 64, no. 3 (2018): 328–33. https://doi.org/10.1097/MAT.0000000000000656.
Ranney DN, Benrashid E, Meza JM, Keenan JE, Bonadonna D, Mureebe L, et al. Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation. ASAIO J. 2018;64(3):328–33.
Ranney, David N., et al. “Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation.ASAIO J, vol. 64, no. 3, 2018, pp. 328–33. Pubmed, doi:10.1097/MAT.0000000000000656.
Ranney DN, Benrashid E, Meza JM, Keenan JE, Bonadonna D, Mureebe L, Cox MW, Daneshmand MA. Vascular Complications and Use of a Distal Perfusion Cannula in Femorally Cannulated Patients on Extracorporeal Membrane Oxygenation. ASAIO J. 2018;64(3):328–333.

Published In

ASAIO J

DOI

EISSN

1538-943X

Publication Date

2018

Volume

64

Issue

3

Start / End Page

328 / 333

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • Risk Factors
  • Retrospective Studies
  • Perfusion
  • Middle Aged
  • Male
  • Leg
  • Ischemia
  • Incidence
  • Humans