Using near-infrared reflectance spectroscopy (NIRS) to assess distal-limb perfusion on venoarterial (V-A) extracorporeal membrane oxygenation (ECMO) patients with femoral cannulation

Perfusion
Killian Patton-RiveraKoji Takeda

Abstract

Patients requiring V-A ECMO who receive femoral cannulation have an associated risk of distal, lower-limb hypoperfusion and ischemia of the cannulated leg. This pilot study evaluated the usefulness of non-invasive lower-limb oximetry, using near-infrared reflectance spectroscopy (NIRS) to detect limb ischemia. Between June 2016 and January 2017, 25 patients receiving femoral V-A ECMO were continuously monitored using the CASMED Fore-Sight Elite (CAS Medical Systems Inc., Branford, CT) tissue oximeter. A retrospective pilot study was conducted to review the correlation between NIRS tissue saturations (StO2) and clinical indications of limb ischemia. Patients were monitored for StO2s less than 50% for more than four minutes or StO2 differentials between the cannulated and non-cannulated legs greater than 15%. Twenty-five patients (age 22-78) were monitored with NIRS. Six patients had clinical indications of lower-limb ischemia: cold limb, mottled skin and pulseless Doppler ultrasound. All six patients had StO2s below 50% that persisted for longer than four minutes. Of the 25 patients, one patient had a false-positive indication of hypoperfusion with StO2 below 50% for more than four minutes due to a venous saturation below 30%. A...Continue Reading

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Citations

Mar 14, 2019·Current Opinion in Critical Care·Sundar Krishnan, Gregory A Schmidt
Apr 30, 2020·Current Opinion in Critical Care·Rajat KalraDemetris Yannopoulos
Sep 15, 2020·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Amit SahaKoji Takeda
Oct 4, 2020·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Michael SalnaKoji Takeda
Aug 1, 2019·Critical Care : the Official Journal of the Critical Care Forum·Eleonora BonicoliniRoberto Lorusso
Oct 8, 2020·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Roberto LorussoDavid A D'Alessandro
Oct 7, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Roberto LorussoDavid A D'Alessandro
Mar 29, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Emily L ChananMark E Nunnally
Sep 19, 2019·Journal of Cardiothoracic and Vascular Anesthesia·Suneel Ramesh Desai, Nian Chih Hwang
Oct 12, 2020·The Journal of Thoracic and Cardiovascular Surgery·Roberto LorussoDavid A D'Alessandro
May 13, 2021·Acute Medicine & Surgery·Marina OiYasushi Asari
Jul 29, 2021·JTCVS Techniques·Koji TakedaHiroo Takayama
Jul 12, 2021·Revista española de anestesiología y reanimación·I ZarragoikoetxeaR Vicente Guillén
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Jul 20, 2020·Lancet·Alain CombesDaniel Brodie
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Apr 6, 2019·The Journal of Thoracic and Cardiovascular Surgery·Scott C DeRooKoji Takeda

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Methods Mentioned

BETA
amputation

Software Mentioned

CASMED

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