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J Thorac Cardiovasc Surg 2004;128:776-777
© 2004 The American Association for Thoracic Surgery

Brief communication

Pressure criterion for placement of distal perfusion catheter to prevent limb ischemia during adult extracorporeal life support

Shu-Chien Huang, MDa, Hsi-Yu Yu, MDa, Wen-Je Ko, MDa, Yih-Sharng Chen, MDa,*

a Department of Surgery, National Taiwan University Hospital, National Taiwan University School of Medicine, Taipei, Taiwan

Received for publication March 15, 2004; accepted for publication March 25, 2004.

* Address for correspondence: Yih-Sharng Chen, MD, Department of Surgery, National Taiwan University Hospital, 7 Chung-Shan S Rd, Taipei 100, Taiwan
yschen11@yahoo.com.tw

The first 20% of the full text of this article appears below.


Drs Yu, Ko, Huang, and Chen (left to right).


Femoral venoarterial extracorporeal membrane oxygenation (ECMO) provides effective cardiopulmonary support for critically ill patients. However, distal leg ischemia is a significant complication after femoral artery cannulation. The clinical decision of in whom and when a distal perfusion catheter should be inserted to prevent limb ischemia remains controversial. We conducted a prospective study by measuring the blood pressure in the superficial femoral artery to select the patients at risk. From our data, we wished to develop a standardized method to prevent limb ischemia in femoral venoarterial ECMO.

Technique

We cannulated patients with a modified open Seldinger method. The femoral vessels were dissected out and the cannulas (BioMedicus cannula; Medtronic BioMedicus, Inc, Minneapolis, Minn) were inserted with a guidewire under direct vision. This method is particularly useful during cardiopulmonary resuscitation with impalpable femoral pulse. Because the surgical instruments are placed on our wheeled ECMO cart, this technique is now . . . [Full Text of this Article]






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