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首页> 外文期刊>Journal of cardiac surgery. >Ankle-brachial index to monitor limb perfusion in patients with femoral venoarterial extracorporeal membrane oxygenation
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Ankle-brachial index to monitor limb perfusion in patients with femoral venoarterial extracorporeal membrane oxygenation

机译：踝臂指数，以监测股骨静脉体外膜氧合患者肢体灌注

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摘要

Background Limb ischemia is a major complication of femoral venoarterial extracorporeal membrane oxygenation (VA-ECMO). Use of ankle-brachial index (ABI) to monitor limb perfusion in VA-ECMO has not been described. We report our experience monitoring femoral VA-ECMO patients with serial ABI and the relationships between ABI and near infrared spectroscopy (NIRS). Methods This is a retrospective single-center review of consecutive adult patients placed on femoral VA-ECMO between January 2019 and October 2019. Data were collected on patients with paired ABI and NIRS values. Relationships between NIRS and ABI of the cannulated (E-NIRS and E-ABI) and non-cannulated legs (N-NIRS and N-ABI) along with the difference between legs (d-NIRS and d-ABI) were determined using Pearson correlation. Results Overall, 22 patients (mean age 56.5 +/- 14.0 years, 72.7% male) were assessed with 295 E-ABI and E-NIRS measurements, and 273 N-ABI and N-NIRS measurements. Mean duration of ECMO support was 129.8 +/- 78.3 h. ECMO-mortality was 13.6% and in-hospital mortality was 45.5%. N-ABI and N-NIRS were significantly higher than their ECMO counterparts (ABI mean difference 0.16, 95% confidence interval [CI]: 0.13-0.19, p < .0001; NIRS mean difference 2.51, 95% CI: 1.48-3.54, p < .0001). There was no correlation between E-ABI versus E-NIRS (r = .032, p = .59), N-ABI versus N-NIRS (r = .097, p = .11), or d-NIRS versus d-ABI (r = .11, p = .069). Conclusion ABI is a quantitative metric that may be used to monitor limb perfusion and supplement clinical exams to identify limb ischemia in femorally cannulated VA-ECMO patients. More studies are needed to characterize the significance of ABI in femoral VA-ECMO and its value in identifying limb ischemia in this patient population.
机译：背景肢体缺血是体外股动脉体外膜肺氧合（VA ECMO）的主要并发症。在VA-ECMO中使用踝臂指数（ABI）监测肢体灌注尚未被描述。我们报告了连续ABI监测股骨VA-ECMO患者的经验，以及ABI与近红外光谱（NIRS）之间的关系。方法回顾性单中心回顾性分析2019年1月至2019年10月连续接受股骨VA-ECMO治疗的成年患者。收集具有配对ABI和NIRS值的患者的数据。利用Pearson相关法确定了插管腿（E-NIRS和E-ABI）和非插管腿（N-NIRS和N-ABI）的近红外光谱和ABI之间的关系，以及腿（d-NIRS和d-ABI）之间的差异。结果共有22名患者（平均年龄56.5+/-14.0岁，男性占72.7%）接受了295次E-ABI和E-NIRS测量，以及273次N-ABI和N-NIRS测量。ECMO支持的平均持续时间为129.8+/-78.3小时。ECMO死亡率为13.6%，住院死亡率为45.5%。N-ABI和N-NIRS显著高于ECMO（ABI平均差异0.16，95%置信区间[CI]：0.13-0.19，p<0.0001；NIRS平均差异2.51，95%置信区间：1.48-3.54，p<0.0001）。E-ABI与E-NIRS（r=0.032，p=0.59）、N-ABI与N-NIRS（r=0.097，p=0.11）或d-NIRS与d-ABI（r=0.11，p=0.069）之间没有相关性。结论ABI是一种定量指标，可用于监测女性插管VA-ECMO患者的肢体灌注，补充临床检查，以确定肢体缺血。需要更多的研究来描述ABI在股骨VA-ECMO中的意义及其在该患者群体中识别肢体缺血的价值。

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  • 来源
    《Journal of cardiac surgery.》 |2021年第9期|共7页
  • 作者

    Son Andre Y.; Karim Azad S.; Joung Rachel Hae-Soo; McGregor Randy; Wu Tingqing; Andrei Adin-Cristian; Pawale Amit; Ho Karen J.; Pham Duc Thinh;

  • 作者单位

    Northwestern Univ Bluhm Cardiovasc Inst Dept Surg Div Cardiac Surg Feinberg Sch Med 676N St;

    Northwestern Univ Bluhm Cardiovasc Inst Dept Surg Div Cardiac Surg Feinberg Sch Med 676N St;

    Northwestern Univ Dept Surg Feinberg Sch Med Chicago IL 60611 USA;

    Northwestern Univ Bluhm Cardiovasc Inst Dept Surg Div Cardiac Surg Feinberg Sch Med 676N St;

    Northwestern Univ Div Biostat Feinberg Sch Med Chicago IL 60611 USA;

    Northwestern Univ Div Biostat Feinberg Sch Med Chicago IL 60611 USA;

    Northwestern Univ Bluhm Cardiovasc Inst Dept Surg Div Cardiac Surg Feinberg Sch Med 676N St;

    Northwestern Univ Dept Surg Div Vasc Surg Feinberg Sch Med Chicago IL 60611 USA;

    Northwestern Univ Bluhm Cardiovasc Inst Dept Surg Div Cardiac Surg Feinberg Sch Med 676N St;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 心脏血管和淋巴系外科学;
  • 关键词

    cardiovascular research;

    机译：心血管研究;

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