000K  utf8
1100  2023$c2023-05-28
1500  eng
2050  urn:nbn:de:hbz:465-20230810-183635-5
2051  10.1016/j.ijcha.2023.101230
3000  Ilias, Christos
3010  Ayoub, George
3010  Kamler, Markus
3010  Koch, Achim
3010  Lainka, Martin
3010  Luedike, Peter
3010  Papathanasiou, Maria
3010  Pizanis, Nikolaos
3010  Rassaf, Tienush
3010  Ruhparwar, Arjang
3010  Schmack, Bastian
4000  Vascular complications after peripheral veno-arterial extracorporeal life support cannulation in cardiogenic shock  [Ilias, Christos]
4209  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 < 0.001). The 6-month survival rate was 28% in our Conclusion: Lower limb ischemia remains a serious complication after peripheral ECLS cannulation in CS, especially when a DPC is absent. Standardised DPC implementation may reduce the rate of severe limb complications in peripheral ECLS.
4950  https://doi.org/10.1016/j.ijcha.2023.101230$xR$3Volltext$534
4950  https://nbn-resolving.org/urn:nbn:de:hbz:465-20230810-183635-5$xR$3Volltext$534
4961  https://duepublico2.uni-due.de/receive/duepublico_mods_00078537
5051  610
5550  Cardiogenic shock
5550  Distal perfusion cannula
5550  Extracorporeal life support
5550  Lower limb ischemia