Lamb Kathleen M, Hirose Hitoshi, Cavarocchi Nicholas C
Department of Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA.
J Card Surg. 2013 Mar;28(2):190-2. doi: 10.1111/jocs.12058. Epub 2013 Feb 5.
The most frequent limb complications from peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done.
Percutaneous cannulation with a distal perfusion port was performed in all patients. During the VA-ECMO, distal limb perfusion was monitored using near-infrared spectroscopy to assess tissue oxygenation. At the decannulation, patch angioplasty was performed to prevent the development of narrowing of the artery at the cannulation site.
Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding.
外周静脉-动脉体外膜肺氧合（VA-ECMO）最常见的肢体并发症是肢体缺血和局部出血。为将这些风险降至最低，采用外周经皮插管对远端肢体进行灌注。
所有患者均采用带远端灌注端口的经皮插管。在VA-ECMO期间，使用近红外光谱监测远端肢体灌注以评估组织氧合。拔管时，进行补片血管成形术以防止插管部位动脉狭窄的发生。
使用我们的标准技术，我们尚未经历任何与缺血或出血相关的肢体丧失情况。
