Krasivskyi Ihor, Großmann Clara, Dechow Marit, Djordjevic Ilija, Ivanov Borko, Gerfer Stephen, Bennour Walid, Kuhn Elmar, Sabashnikov Anton, Rahmanian Parwis Baradaran, Mader Navid, Eghbalzadeh Kaveh, Wahlers Thorsten
Department of Cardiothoracic Surgery, University Hospital Cologne, 50937 Cologne, Germany.
Department of Cardiothoracic Surgery, Heart Centre, Helios Hospital Siegburg, 53721 Siegburg, Germany.
Life (Basel). 2023 Feb 10;13(2):485. doi: 10.3390/life13020485.
The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock is rising. Acute limb ischaemia remains one of the main complications after ECMO initiation. We analysed 104 patients from our databank from January 2015 to December 2021 who were supported with mobile ECMO therapy. We aimed to identify the impact of acute limb ischaemia on short-term outcomes in patients placed on ECMO in our institution. The main indication for ECMO therapy was left ventricular (LV) failure with cardiogenic shock (57.7%). Diameters of arterial cannulas ( = 0.365) showed no significant differences between both groups. Furthermore, concomitant intra-aortic balloon pump (IABP, = 0.589) and Impella ( = 0.385) implantation did not differ significantly between both groups. Distal leg perfusion was established in approximately 70% of patients in two groups with no statistically significant difference ( = 0.960). Acute limb ischaemia occurred in 18.3% of cases (n = 19). In-hospital mortality was not significantly different ( = 0.799) in both groups. However, the bleeding rate was significantly higher ( = 0.005) in the limb ischaemia group compared to the no-limb ischaemia group. Therefore, early diagnosis and prevention of acute limb ischaemia might decrease haemorrhage complications in patients during ECMO therapy.
用于心源性休克的静脉-动脉体外膜肺氧合（VA-ECMO）的使用正在增加。急性肢体缺血仍然是启动ECMO后的主要并发症之一。我们分析了2015年1月至2021年12月我们数据库中接受移动ECMO治疗的104例患者。我们旨在确定急性肢体缺血对我们机构中接受ECMO治疗患者短期结局的影响。ECMO治疗的主要指征是左心室（LV）衰竭合并心源性休克（57.7%）。两组之间动脉插管直径（=0.365）无显著差异。此外，两组之间主动脉内球囊泵（IABP，=0.589）和Impella（=0.385）植入情况无显著差异。两组中约70%的患者建立了小腿远端灌注，差异无统计学意义（=0.960）。18.3%的病例（n = 19）发生急性肢体缺血。两组的院内死亡率无显著差异（=0.799）。然而，与无肢体缺血组相比，肢体缺血组的出血率显著更高（=0.005）。因此，急性肢体缺血的早期诊断和预防可能会减少ECMO治疗期间患者的出血并发症。
