What Factors Are Associated With Arterial Line-Related Limb Ischemia in Patients on Extracorporeal Membrane Oxygenation? A Single-Center Retrospective Cohort Study.
arterial line
extracorporeal membrane oxygenation
finger ischemia
gangrene
limb ischemia
Journal
Journal of cardiothoracic and vascular anesthesia
ISSN: 1532-8422
Titre abrégé: J Cardiothorac Vasc Anesth
Pays: United States
ID NLM: 9110208
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
received:
31
03
2023
revised:
27
06
2023
accepted:
14
08
2023
medline:
6
11
2023
pubmed:
22
9
2023
entrez:
21
9
2023
Statut:
ppublish
Résumé
The primary purpose of this study was to identify factors associated with the development of arterial line-related limb ischemia in patients on extracorporeal membrane oxygenation (ECMO). The authors also sought to characterize and report the outcomes of patients who developed arterial line-related limb ischemia. Retrospective cohort study. A single academic tertiary referral ECMO center. Consecutive patients who were treated with ECMO over 6 years. Use of arterial line. A total of 278 consecutive ECMO patients were included, with 19 (7%) patients developing arterial line-related limb ischemia during the ECMO run. Postcannulation Sequential Organ Failure Assessment (SOFA) (adjusted odds ratio [aOR] 1.20, 95% CI 1.08-1.32), Acute Physiology and Chronic Health Evaluation-II (aOR 0.84, 95% CI 0.74-0.95), and adjusted Vasopressor Dose Equivalence (aOR 1.03, 95% CI 1.01-1.05) scores were independently associated with the development of arterial line-associated limb ischemia. A SOFA score of ≥17 at the time of ECMO cannulation had an 80% sensitivity and 87% specificity for predicting arterial line-related limb ischemia. Arterial line-related limb ischemia is much more common in ECMO patients than in the typical intensive care unit setting. The SOFA score may be useful in identifying which patients may be at risk for arterial line-related limb ischemia. As this was a single-center retrospective study, these results are inherently exploratory, and prospective multicenter studies are necessary to validate these results.
Identifiants
pubmed: 37735020
pii: S1053-0770(23)00700-0
doi: 10.1053/j.jvca.2023.08.131
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2489-2498Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Babar Shafiq is a paid consultant for Bone Foam Inc., Smith & Nephew, and DePuy Synthes. He is on the editorial board for Frontiers in Surgery, Orthopedic Surgery, and is a board/committee member for the Orthopedic Trauma Association. He also receives research support from DePuy Synthes.