中国体外循环杂志2019，Vol.17Issue(1)：22-25,4.DOI:10.13498/j.cnki.chin.j.ecc.2019.01.06
经股动静脉体外膜肺氧合下肢并发症的防治及管理策略
Prevention and management strategy of lower extremity complications after extracorporeal membrane oxygenation via femoral artery and vein
郭剑 1卢安东 1苗莉霞 1闵凯1
作者信息
- 1. 联勤保障部队第九四〇医院心血管外科 730050 兰州
- 折叠
摘要
Abstract
Objective To summarize the prevention and management strategy of lower extremity ischemia and thrombotic complications during femoral arteriovenous extracorporeal membrane oxygenation (ECMO). Methods Clinical data of 22 patients with ECMO (V-A mode) assisted treatment for circulatory failure from May 2014 to March 2018 were analyzed retrospectively. The distal end of lower extremity perfusion and complications of those patients were also analyzed. Results Of the 22 patients, 13 cases were successfully weaned from ECMO (59.1％). During 2014 and 2016, a distal perfusion cannula was routinely placed through superficial femoral artery (17 cases); from 2017 to present, distal perfusion cannulation was not routinely placed, and the placement was decided according to the clinical situation and lower extremity ultrasound blood flow (Of five cases, three were not cannulated whereas two were cannulated thereafter). Among them, three patients suffered from lower extremity swelling. There were two cases of macula, which improved after the distal perfusion tube was placed under the guidance of ultrasound, and no lower limb ischemia or necrosis occurred.Conclusion ECMO plays an important role in the treatment of acute circulatory failure. Lower extremity complications have great impacts on the prognosis. According to the conditions of patients, rational placement of distal perfusion, anticoagulant and distal flow management are needed to reduce the rate of disability and to improve the success rate of ECMO and the life quality of patients.关键词
体外膜肺氧合/下肢并发症/远端灌注/缺血/静脉血栓Key words
Extracorporeal membrane oxygenation/Lower extremity complication/Distal perfusion/Ischemia/Venous thrombosis引用本文复制引用
郭剑,卢安东,苗莉霞,闵凯..经股动静脉体外膜肺氧合下肢并发症的防治及管理策略[J].中国体外循环杂志,2019,17(1):22-25,4.
