How to do itUsing Near-Infrared Spectroscopy to Monitor Lower Extremities in Patients on Venoarterial Extracorporeal Membrane Oxygenation
Section snippets
Technique
Approval was obtained by the Cleveland Clinic Institutional Review Board. Five patients who underwent peripheral VA ECMO cannulation through the femoral artery and vein underwent continuous monitoring using NIRS (Foresight System; CAS Medical Systems, Branford, CT). Sensors were placed on the calf of each lower extremity. Tissue oxygen saturation (stO2) was continuously monitored starting at the time of ECMO insertion. The patients' clinical events were obtained from the electronic medical
Comment
Improvements made in long-term mechanical circulatory support may encourage the use of ECMO as there is now a potential solution for patients in cardiogenic shock. To minimize injuries to the lower extremities, improvement is needed in monitoring tissue perfusion to diagnose complications before they become irreversible. As seen in Table 1, stO2 in the cannulated leg of less than 54% and a difference in stO2 between the legs of greater than 35% were unique to patients who had limb complications.
References (6)
- et al.
Extracorporeal membrane oxygenation support for adult postcardiotomy cardiogenic shock
Ann Thorac Surg
(2002) - et al.
Clinical experience with 202 adults receiving extracorporeal membrane oxygenation for cardiac failure: survival at five years
J Thorac Cardiovasc Surg
(2001) - et al.
Arterial complications in patients undergoing extracorporeal membrane oxygenation via femoral cannulation
Ann Vasc Surg
(2014)