초록접수 현황
| 17F-114 | 구연 발표 |
Near-infrared Spectroscopy Monitoring for Early Detection of Limb Ischemia in Patients on Veno-Arterial Extracorporeal Membrane Oxygenation
Dong Jung Kim, Sang Yoon Kim, Su Ryeun Chung, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
Purpose : We previously reported our one-year experience of continuous near-infrared spectroscopy (NIRS) monitoring for the early detection of lower limb ischemia following femoral cannulation in patients undergoing veno-arterial extracorporeal membrane oxygenation (VA-ECMO). For the past five years, our institution has routinely used NIRS monitoring in VA-ECMO patients. In this report, we provide our experience of real-time NIRS monitoring for a timely diagnosis of limb ischemia in VA-ECMO patients.
Methods : We retrospectively reviewed medical records of patients who were supported with VA-ECMO between September 2013 and August 2017. Distal perfusion catheterization was performed only in patients who exhibit a significant drop in the regional oxygen saturation (rSO2) values provided by the NIRS system.
Results : Between September 2013 and August 2017, 230 patients underwent VA-ECMO support. Of these, 120 adult patients who were supported with peripheral VA-ECMO for more than 24 hours were included. 36 patients underwent distal perfusion because because their rSO2 values were significantly dropped. The median time to distal perfusion was 3.6 hours. No patient underwent fasciotomy due to the development of compartment syndrome. There was no case requiring amputation.
Conclusion : We think that NIRS monitoring is a useful and reliable method for the early detection of limb ischemia in adult patients undergoing peripheral VA-ECMO. Its application may allow timely correction of perfusion deficits and the prevention of compartment syndrome and limb complications. We think it can also improve the quality of care and outcomes of critically ill ECMO patients.
Methods : We retrospectively reviewed medical records of patients who were supported with VA-ECMO between September 2013 and August 2017. Distal perfusion catheterization was performed only in patients who exhibit a significant drop in the regional oxygen saturation (rSO2) values provided by the NIRS system.
Results : Between September 2013 and August 2017, 230 patients underwent VA-ECMO support. Of these, 120 adult patients who were supported with peripheral VA-ECMO for more than 24 hours were included. 36 patients underwent distal perfusion because because their rSO2 values were significantly dropped. The median time to distal perfusion was 3.6 hours. No patient underwent fasciotomy due to the development of compartment syndrome. There was no case requiring amputation.
Conclusion : We think that NIRS monitoring is a useful and reliable method for the early detection of limb ischemia in adult patients undergoing peripheral VA-ECMO. Its application may allow timely correction of perfusion deficits and the prevention of compartment syndrome and limb complications. We think it can also improve the quality of care and outcomes of critically ill ECMO patients.
책임저자: Dong Jung Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Gyeonggi-do, Republic of Korea
발표자: Dong Jung Kim, E-mail : mdknockout@snubh.org