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Crit Care Clin. 2017 Oct;33(4):813-824. doi: 10.1016/j.ccc.2017.06.004. Epub 2017 Jul 28.

Vascular Complications in Extracoporeal Membrane Oxygenation.

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Division of Vascular Surgery and Endovascular Therapy, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 19104, USA. Electronic address:
Department of Cardiothoracic Surgery, Thomas Jefferson University Hospital, 1100 Walnut Street, 5th Floor, Philadelphia, PA 19107, USA.


Venoarterial extracorporeal membrane oxygenation is a rescue therapy in patients with severe cardiopulmonary failure. Often, cannulation is done emergently and the femoral vessels are most readily accessible for venous and arterial access. Unfortunately, complications with arterial femoral access can lead to devastating complications, primarily related to limb ischemia. A coordinated protocol of diligent limb examination by trained intensive care unit staff, near infrared spectroscopy monitoring of limbs, and placement of a distal perfusion catheter at the time of femoral cannulation or when signs of ischemia develop, can lead to successful limb salvage.


Arterial dissection; Infectious arterial complications; Limb salvage; Pseudoaneurysm; Thromboembolic complications; Vascular complications; Venoarterial extracorporeal membrane oxygenation

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