Vascular complications after peripheral veno-arterial extracorporeal life support cannulation in cardiogenic shock

Autor: Christos Ilias, Achim Koch, Maria Papathanasiou, Peter Luedike, Tienush Rassaf, Bastian Schmack, George Ayoub, Martin Lainka, Arjang Ruhparwar, Markus Kamler, Nikolaus Pizanis
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: International Journal of Cardiology: Heart & Vasculature, Vol 47, Iss , Pp 101230- (2023)
Druh dokumentu: article
ISSN: 2352-9067
DOI: 10.1016/j.ijcha.2023.101230
Popis: Background: Extra Corporeal Life Support (ECLS) is an evolving therapy in therapy-resistant cardiogenic shock (CS). Vascular cannulation in emergency situations can be accomplished through puncture of the femoral vessels by specialised teams. Since lower limb ischemia constitutes one of the major complications following cannulation, a distal perfusion cannula (DPC) has emerged as standard of care. We here aimed to analyse the impact of the DPC on limb perfusion and 6-month survival rate. Methods: In a retrospective study from January 2012 to December 2018, 98 patients with cardiogenic shock and peripheral (v-a) ECLS implantation with documented limb perfusion status were identified and analysed. Demographic data, laboratory parameters, cause of CS, comorbidities, limb perfusion complications and complication management were analysed. Results: 53 patients (54%) received ECLS therapy in referral centers by our mobile ECLS team, while in 45 patients (46%) the cannulation occured in our center. 71 patients (72%) received a DPC (group A) at the time of ECLS implantation, whereas 27 (28%) (group B) did not or received later (14 patients owing to limb ischemia). 44 patients (45%) developed limb ischemia as a complication of ECLS therapy (31% in group A and 81% in group B- p
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