股静脉-动脉体外膜肺氧合治疗中对侧下肢缺血

Contralateral Lower Extremity Ischemia on Femoral Veno-Arterial Extracorporeal Membrane Oxygenation.

作者信息

Arons Danielle, Dave Sagar, Shah Aakash, Deatrick Kristopher B

机构信息

From the Division of Cardiac Surgery, University of Maryland School of Medicine, Baltimore, Maryland.

Departments of Emergency Medicine and Anesthesia, Division of Critical Care, Emory University School of Medicine, Atlanta, Georgia.

出版信息

ASAIO J. 2023 Mar 1;69(3):e128-e130. doi: 10.1097/MAT.0000000000001832. Epub 2022 Oct 26.

DOI:10.1097/MAT.0000000000001832

PMID:36730954

Abstract

Ipsilateral lower extremity ischemia is a common and morbid complication during veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The cannula can impede ipsilateral distal arterial flow leading to critical limb ischemia. Cannula size, placement, and utilization of distal perfusion catheters are strategies that have been used to prevent this complication. We report the novel case of a 19-year-old female on VA-ECMO complicated by contralateral lower extremity ischemia. Diagnosis was made by computed tomography, and with repositioning of the femoral arterial cannula, she had a complete resolution of symptoms.

摘要

同侧下肢缺血是静脉-动脉体外膜肺氧合（VA-ECMO）期间常见且严重的并发症。插管可阻碍同侧远端动脉血流，导致严重肢体缺血。插管尺寸、放置位置以及使用远端灌注导管是已用于预防该并发症的策略。我们报告了一例19岁女性在VA-ECMO期间并发对侧下肢缺血的罕见病例。通过计算机断层扫描做出诊断，随着股动脉插管重新定位，她的症状完全缓解。