Lower limb amputation following venous cannulation for VA-ECMO: a case report
| Autor: | Fady Haddad, Natasha Habr, Jamal J. Hoballah, Pierre Sfeir, Jamil Borgi, Caroline Hamadi |
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| Rok vydání: | 2021 |
| Předmět: |
Advanced and Specialized Nursing
business.industry medicine.medical_treatment Ischemia Hemodynamics General Medicine medicine.disease Cannula Fasciotomy surgical procedures operative Amputation Lower limb amputation Anesthesia Shock (circulatory) Medicine Radiology Nuclear Medicine and imaging medicine.symptom Cardiology and Cardiovascular Medicine business Safety Research Venous cannulation |
| Zdroj: | Perfusion. 38:414-417 |
| ISSN: | 1477-111X 0267-6591 |
| Popis: | Lower limb amputation following arterial cannulation for VA-ECMO has been described in the literature. Limb ischemia however following venous cannulation is very rare and not quite understood. We present a case of limb ischemia following venous cannulation. A combination of venous congestion, compartment syndrome and subsequent arterial insufficiency is the proposed pathophysiology. Shock and use of vasopressors are compounding factors. Limb ischemia can be transient and reversible if diagnosed immediately and treated by early removal of the cannula. Our patient was unstable and ECMO dependent, and removal of the cannula was not an option. This resulted in limb loss and eventual above knee amputation. Use of the smallest appropriate venous cannula and early fasciotomy, in addition to hemodynamic optimization are measures that could help in preventing major amputation. |
| Databáze: | OpenAIRE |
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