Arterial access complications in patients with extracorporeal membrane oxygenation - literature review

Detalhes bibliográficos
Autor(a) principal: Nóbrega,Leandro
Data de Publicação: 2024
Outros Autores: Dias,Lara, Moura,Tiago, Dias,Pedro Paz, Sousa,Joel, Roncon,Roberto, Mansilha,Armando
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2024000200068
Resumo: Abstract Introduction: The use of extracorporeal membrane oxygenation (ECMO) has been increasing in recent years. Veno-Arterial ECMO (ECMO-VA) is usually deployed in refractory cardiac failure and is mostly cannulated through the common femoral artery. When present, arterial access complications may have important consequences in these patients. Therefore, this work aims to narratively review the available evidence regarding the impact of arterial access complications in patients undergoing ECMO-VA. Methods: A Medline search was performed to identify articles focused on arterial access complications in patients undergoing ECMO-VA since 2010. The keywords were “extracorporeal membrane oxygenation,” “arterial access,” and “complications.” The primary endpoints were the description of the arterial complication with demographic characteristics and the short- and long-term prognosis. Results: The incidence of vascular complications in patients undergoing ECMO-VA ranges from 9.4% to 43.9%. In the majority of retrospective studies, their presence isn’t associated with increased mortality. However, in a meta-analysis, there was an increased mortality in patients with complications (RR 1.36; CI 95% 1.15-1.60; P=0.0004). The main risk factors are peripheral artery disease and female sex, while the reduced case volume can be associated with increased complications. Conclusion: Most available evidence on managing arterial complications associated with ECMO derives from retrospective studies. To decrease the risk of access complications, protocols for cannulation, surveillance, and decannulation should be elaborated. Prospective studies are needed to improve the prevention and management of vascular access complications in patients under ECMO-VA.
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spelling Arterial access complications in patients with extracorporeal membrane oxygenation - literature reviewExtracorporeal membrane oxygenationMortalityPeripheral Artery DiseaseAbstract Introduction: The use of extracorporeal membrane oxygenation (ECMO) has been increasing in recent years. Veno-Arterial ECMO (ECMO-VA) is usually deployed in refractory cardiac failure and is mostly cannulated through the common femoral artery. When present, arterial access complications may have important consequences in these patients. Therefore, this work aims to narratively review the available evidence regarding the impact of arterial access complications in patients undergoing ECMO-VA. Methods: A Medline search was performed to identify articles focused on arterial access complications in patients undergoing ECMO-VA since 2010. The keywords were “extracorporeal membrane oxygenation,” “arterial access,” and “complications.” The primary endpoints were the description of the arterial complication with demographic characteristics and the short- and long-term prognosis. Results: The incidence of vascular complications in patients undergoing ECMO-VA ranges from 9.4% to 43.9%. In the majority of retrospective studies, their presence isn’t associated with increased mortality. However, in a meta-analysis, there was an increased mortality in patients with complications (RR 1.36; CI 95% 1.15-1.60; P=0.0004). The main risk factors are peripheral artery disease and female sex, while the reduced case volume can be associated with increased complications. Conclusion: Most available evidence on managing arterial complications associated with ECMO derives from retrospective studies. To decrease the risk of access complications, protocols for cannulation, surveillance, and decannulation should be elaborated. Prospective studies are needed to improve the prevention and management of vascular access complications in patients under ECMO-VA.Sociedade Portuguesa de Angiologia e Cirurgia Vascular2024-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2024000200068Angiologia e Cirurgia Vascular v.20 n.2 2024reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2024000200068Nóbrega,LeandroDias,LaraMoura,TiagoDias,Pedro PazSousa,JoelRoncon,RobertoMansilha,Armandoinfo:eu-repo/semantics/openAccess2024-11-07T23:00:52Zoai:scielo:S1646-706X2024000200068Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-11-07T23:00:52Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
title Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
spellingShingle Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
Nóbrega,Leandro
Extracorporeal membrane oxygenation
Mortality
Peripheral Artery Disease
title_short Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
title_full Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
title_fullStr Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
title_full_unstemmed Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
title_sort Arterial access complications in patients with extracorporeal membrane oxygenation - literature review
author Nóbrega,Leandro
author_facet Nóbrega,Leandro
Dias,Lara
Moura,Tiago
Dias,Pedro Paz
Sousa,Joel
Roncon,Roberto
Mansilha,Armando
author_role author
author2 Dias,Lara
Moura,Tiago
Dias,Pedro Paz
Sousa,Joel
Roncon,Roberto
Mansilha,Armando
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Nóbrega,Leandro
Dias,Lara
Moura,Tiago
Dias,Pedro Paz
Sousa,Joel
Roncon,Roberto
Mansilha,Armando
dc.subject.por.fl_str_mv Extracorporeal membrane oxygenation
Mortality
Peripheral Artery Disease
topic Extracorporeal membrane oxygenation
Mortality
Peripheral Artery Disease
description Abstract Introduction: The use of extracorporeal membrane oxygenation (ECMO) has been increasing in recent years. Veno-Arterial ECMO (ECMO-VA) is usually deployed in refractory cardiac failure and is mostly cannulated through the common femoral artery. When present, arterial access complications may have important consequences in these patients. Therefore, this work aims to narratively review the available evidence regarding the impact of arterial access complications in patients undergoing ECMO-VA. Methods: A Medline search was performed to identify articles focused on arterial access complications in patients undergoing ECMO-VA since 2010. The keywords were “extracorporeal membrane oxygenation,” “arterial access,” and “complications.” The primary endpoints were the description of the arterial complication with demographic characteristics and the short- and long-term prognosis. Results: The incidence of vascular complications in patients undergoing ECMO-VA ranges from 9.4% to 43.9%. In the majority of retrospective studies, their presence isn’t associated with increased mortality. However, in a meta-analysis, there was an increased mortality in patients with complications (RR 1.36; CI 95% 1.15-1.60; P=0.0004). The main risk factors are peripheral artery disease and female sex, while the reduced case volume can be associated with increased complications. Conclusion: Most available evidence on managing arterial complications associated with ECMO derives from retrospective studies. To decrease the risk of access complications, protocols for cannulation, surveillance, and decannulation should be elaborated. Prospective studies are needed to improve the prevention and management of vascular access complications in patients under ECMO-VA.
publishDate 2024
dc.date.none.fl_str_mv 2024-06-01
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format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2024000200068
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dc.language.iso.fl_str_mv eng
language eng
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Angiologia e Cirurgia Vascular
publisher.none.fl_str_mv Sociedade Portuguesa de Angiologia e Cirurgia Vascular
dc.source.none.fl_str_mv Angiologia e Cirurgia Vascular v.20 n.2 2024
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv mluisa.alvim@gmail.com
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