Use of distal perfusion in peripheral extracorporeal membrane oxygenation

Makdisi, George; Makdisi, Tony; Wang, I-Wen

doi:10.21037/atm.2017.03.01

Cited by 45 publications

(32 citation statements)

References 22 publications

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“…This attention is further reduced due to the results of studies such as a meta-analysis with 1866 patients in VA ECMO who reported a 16.9% incidence of lower extremity ischemia. 18 It is assessed that, in this situation, the ECMO team intervene, as the specialist nurses identified early the reduction of the perfusion of the catheterized limb signaling it to the medical staff, making it necessary to change the device.…”

Section: Objective Methodsmentioning

confidence: 99%

Atuação do time de enfermeiros na ressuscitação cardiopulmonar extracorpórea

Saraiva¹,

Fernandes²,

Sousa³

2018

Rev enferm UFPE on line.

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RESUMOObjetivo: apresentar a atuação de um time de enfermeiros especialistas na assistência ao paciente submetido à ECMO-VA pós-parada cardíaca. Método: trata-se de estudo qualitativo, descritivo, retrospectivo, na modalidade do estudo de caso, realizado em um hospital filantrópico. Compôs-se a amostra por uma jovem de 18 anos, em que se analisou o prontuário médico e o resultado se apresentou em forma de relato. Resultados: ressalta-se que o estabelecimento de um time bem estruturado, com atuação do enfermeiro na assistência integral contribuíram para evolução do quadro clínico do paciente pós parada cardiorrespiratória resulta em sua recuperação e alta hospitalar. Informa-se que time atuou de forma contínua desde a canulação até a sua retirada, para o cuidado da paciente em ECMO. Conclusão: salienta-se que a atuação do time foi indispensável para um cuidado especializado e um desfecho favorável na assistência à paciente durante todo o seu período em suporte circulatório. Descritores: Oxigenação por Membrana Extracorpórea; Cuidados de Enfermagem; Parada Cardíaca; Reanimação Cardiopulmonar; Avaliação de Resultados da Assistência ao Paciente; Relatos de Casos.ABSTRACT Objective: to present the work of a team of specialist nurses in the care of patients submitted to ECMO-VA after cardiac arrest. Method: this is a qualitative, descriptive, retrospective study, in the modality of the case study, carried out in a philanthropic hospital. The sample was composed by an 18-year-old girl, who analyzed the medical record and the result was presented in the form of a report. Results: it is emphasized that the establishment of a well-structured team with a nurse's role in the integral care contributed to the evolution of the clinical picture of the patient after cardiorespiratory arrest results in their recovery and hospital discharge. It is reported that the team worked continuously from cannulation until its withdrawal, to the care of the patient in ECMO. Conclusion: it should be noted that the team's performance was indispensable for specialized care and a favorable outcome in patient care throughout their period of circulatory support. Descriptors: Extracorporeal Membrane Oxygenation; Nursing Care; Heart Arrest; Cardiopulmonary Resuscitation; Patient Outcome Assessment; Case Reports.RESUMEN Objetivo: presentar la actuación de un equipo de enfermeros especialistas en la asistencia al paciente sometido a la ECMO-VA post-parada cardiaca. Método: se trata de un estudio cualitativo, descriptivo, retrospectivo, en la modalidad del estudio de caso, realizado en un hospital filantrópico. Se compuso la muestra por una joven de 18 años, en la que se analizó el prontuario médico y el resultado se presentó en forma de relato. Resultados: se resalta que el establecimiento de un equipo bien estructurado, con actuación del enfermero en la asistencia integral, contribuyó para la evolución del cuadro clínico del paciente pos paro cardiorrespiratorio resulta en su recuperación y alta hospitalaria. Se informa que el equipo actuó de forma continua desde la canulación hasta su retirada, para el cuidado de la paciente en ECMO. Conclusión: se destaca que la actuación del equipo fue indispensable para un cuidado especializado y un desenlace favorable en la asistencia al paciente durante todo su período en soporte circulatorio. Descriptores: Oxigenación por Membrana Extracorporea; Atención de Enfermería; Paro Cardíaco; Reanimación Cardiopulmonar; Evaluación del Resultado de la Atención al Paciente; Informes de Casos.

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Section: Objective Methodsmentioning

confidence: 99%

Atuação do time de enfermeiros na ressuscitação cardiopulmonar extracorpórea

Saraiva¹,

Fernandes²,

Sousa³

2018

Rev enferm UFPE on line.

View full text Add to dashboard Cite

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“…The risk can be minimized with placement of a distal perfusion cannula or by cannulating the femoral artery via a chimney graft. 16 In veno-venoarterial ECMO, a second venous drainage cannula is placed (such that there are now drainage cannulae within both the IVC via the femoral vein and the SVC via the internal jugular vein), and the 2 venous cannulae are connected via a Y-adapter. In venoarterial-venous ECMO, oxygenated blood is returned to both an arterial cannula and a separate venous delivery cannula commonly placed via the jugular vein.…”

Section: Types Of Ecmo and Cannulation Optionsmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Kwak

Majewski

Jellish

2020

Journal of Cardiothoracic and Vascular Anesthesia

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“…Femoral arterial cannulation carries an increased risk of profound distal limb ischemia. Some of the causes that lead to lower limb ischemia during ECMO support are acute embolism, dissection/perforation or rupture of the common femoral artery (CFA) or the iliac artery, thrombosis, pseudoaneurysm, hyperperfusion, and ischemia after decannulation usually due to distal embolization [22]. This problem has been solved to a large extent by prophylactically placing an ipsilateral perfusion catheter [22].…”

Section: Limb Ischemiamentioning

confidence: 99%

“…Some of the causes that lead to lower limb ischemia during ECMO support are acute embolism, dissection/perforation or rupture of the common femoral artery (CFA) or the iliac artery, thrombosis, pseudoaneurysm, hyperperfusion, and ischemia after decannulation usually due to distal embolization [22]. This problem has been solved to a large extent by prophylactically placing an ipsilateral perfusion catheter [22]. In a small study using 43 patients who underwent femoral artery cannulation, placement of a prophylactic superficial femoral artery [SFA] catheter in ten patients produced no limb ischemia.…”

Section: Limb Ischemiamentioning

confidence: 99%

Extracorporeal Membrane Oxygenation as a Bridge to Cardiac Transplantation

Nair¹,

Góngora²

2019

Advances in Extracorporeal Membrane Oxygenation - Volume 3

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Extracorporeal membrane oxygenation (ECMO) is a technique used for temporary support of patients with end-stage heart or lung failure. This review will focus on the venoarterial ECMO system and its use as a bridge to other long-term durable devices and/or cardiac transplantation. It can be used as a bridge to decision because it helps to gain time to stabilize the patient for further evaluation for long-term treatment such as durable mechanical circulatory pumps or transplantation. ECMO is evolving as a treatment for patients waiting on the transplant list. Increasing utilization of ECMO in adults has revealed some of the common complications such as bleeding and coagulopathy which impact survival in this patient population. The use of VA ECMO as a technique for rescuing patients from cardiogenic shock is very attractive. However, considering the extensive set of complications and the mortality it brings with it makes it a less attractive option as a direct bridge to cardiac transplant. The literature currently on this subject is very scanty and limited to a few studies of small numbers of patients. Further definitive research is needed for consensus on the role of VA ECMO as a bridge to cardiac transplant.

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Use of distal perfusion in peripheral extracorporeal membrane oxygenation

Cited by 45 publications

References 22 publications

Atuação do time de enfermeiros na ressuscitação cardiopulmonar extracorpórea

Atuação do time de enfermeiros na ressuscitação cardiopulmonar extracorpórea

Extracorporeal Membrane Oxygenation: The New Jack-of-All-Trades?

Extracorporeal Membrane Oxygenation as a Bridge to Cardiac Transplantation

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