Original articleAdult cardiacVascular Complications in Patients Undergoing Femoral Cannulation for Extracorporeal Membrane Oxygenation Support
Section snippets
Patients and Methods
A retrospective review of our prospectively obtained database for ECMO devices implanted between January 2005 and December 2009 indicated 242 patients requiring temporary ECMO support. Excluding patients younger than 16 years and patients dying within 12 hours after ECMO implantation, we included 174 patients (72%) undergoing ECMO support through femoral cannulation. Patients with central or subclavian artery cannulation were excluded as well. The Institutional Ethics Committee approved our
Results
The venoarterial ECMO mode was used in 143 patients (82%). Femoral arterial access was established by percutaneous cannulation in 136 (95%) and by open vessel exposure in 7 (5%). A percutaneous venovenous mode was used in 31 patients (18%).
Comment
Early VCs were observed in 10% of our patients, without any additional midterm vascular events among patients successfully weaned from ECMO. The majority of VCs was observed in the venoarterial mode and was severe. Six compartment syndromes—three as initial clinical manifestation—and two limb amputations were observed. In patients with venovenous mode, only accidental groin hematomas appeared.
The utmost challenge for the prevention of such complications is the rapid clinical diagnosis of
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