초록접수 현황
| 17F-180 | 포럼 발표 |
Prevention of Limb Ischemia in Children with VA ECMO through Femoral Artery
Jeong-hee Yun, Ji-Hyuk Yang, Tae-Gook Jun, Yang Hyun Cho, Kiick Sung, Young Tak Lee
Departments of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Purpose : Limb ischemia after femoral artery cannulation for VA ECMO is common and severe complication. Pediatric patients have higher risk of limb ischemia and a previous study reported 52% of their pediatric VA ECMO patients underwent limb ischemia.
Several prevention strategies are known in adults but there is little experience in small children. We have applied side-arm graft technique to pediatric VA ECMO patient with femoral artery cannulation to overcome this problem since 2007
Methods : We reviewed 149 pediatric ECMO cases between January, 2004 and December 2016 retrospectively. 85 patients underwent VA ECMO and 39 patients underwent femoral artery cannulation. Central ECMO and Peripheral VA ECMO via neck approach cases were excluded.
We divided the 39 patients into 3 groups (direct cannulation, distal perfusion catheter, side-arm graft group) and compared incidence of limb ischemia between the groups.
Results : 5 patients out of 39 patients underwent limb ischemia. 3 patients were in direct cannulation group and 2 patients were in distal perfusion catheter group. There was no limb ischemia in side-arm graft group.
There was no statistically significant difference in limb ischemia incidence between 3 groups. Among the patients who had limb ischemia, 1 patient underwent fasciotomy and all of the 5 patients died.
Conclusion : Although the results were not statistically significant, femoral artery cannulation via side-arm graft tend to result in less limb ischemia in pediatric VA ECMO patients.
We recommend Side-arm graft technique in small children for sufficient blood flow and prevention of limb ischemia.
Several prevention strategies are known in adults but there is little experience in small children. We have applied side-arm graft technique to pediatric VA ECMO patient with femoral artery cannulation to overcome this problem since 2007
Methods : We reviewed 149 pediatric ECMO cases between January, 2004 and December 2016 retrospectively. 85 patients underwent VA ECMO and 39 patients underwent femoral artery cannulation. Central ECMO and Peripheral VA ECMO via neck approach cases were excluded.
We divided the 39 patients into 3 groups (direct cannulation, distal perfusion catheter, side-arm graft group) and compared incidence of limb ischemia between the groups.
Results : 5 patients out of 39 patients underwent limb ischemia. 3 patients were in direct cannulation group and 2 patients were in distal perfusion catheter group. There was no limb ischemia in side-arm graft group.
There was no statistically significant difference in limb ischemia incidence between 3 groups. Among the patients who had limb ischemia, 1 patient underwent fasciotomy and all of the 5 patients died.
Conclusion : Although the results were not statistically significant, femoral artery cannulation via side-arm graft tend to result in less limb ischemia in pediatric VA ECMO patients.
We recommend Side-arm graft technique in small children for sufficient blood flow and prevention of limb ischemia.
첨부파일 : 초록 ppt 최종.pptx
책임저자: Ji-Hyuk Yang
Departments of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
발표자: Jeong-hee Yun, E-mail : yjhms08@naver.com