PMID- 34155679
OWN - NLM
STAT- MEDLINE
DCOM- 20210811
LR  - 20210811
IS  - 1540-8191 (Electronic)
IS  - 0886-0440 (Linking)
VI  - 36
IP  - 9
DP  - 2021 Sep
TI  - Ankle-brachial index to monitor limb perfusion in patients with femoral 
      venoarterial extracorporeal membrane oxygenation.
PG  - 3119-3125
LID - 10.1111/jocs.15757 [doi]
AB  - 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.
CI  - (c) 2021 Wiley Periodicals LLC.
FAU - Son, Andre Y
AU  - Son AY
AUID- ORCID: 0000-0001-8205-9791
AD  - Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular 
      Institute, Northwestern University Feinberg School of Medicine, Chicago, 
      Illinois, USA.
FAU - Karim, Azad S
AU  - Karim AS
AUID- ORCID: 0000-0002-0770-8082
AD  - Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular 
      Institute, Northwestern University Feinberg School of Medicine, Chicago, 
      Illinois, USA.
FAU - Joung, Rachel Hae-Soo
AU  - Joung RH
AUID- ORCID: 0000-0002-4120-1058
AD  - Department of Surgery, Northwestern University Feinberg School of Medicine, 
      Chicago, Illinois, USA.
FAU - McGregor, Randy
AU  - McGregor R
AD  - Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular 
      Institute, Northwestern University Feinberg School of Medicine, Chicago, 
      Illinois, USA.
FAU - Wu, Tingqing
AU  - Wu T
AD  - Division of Biostatistics, Northwestern University Feinberg School of Medicine, 
      Chicago, Illinois, USA.
FAU - Andrei, Adin-Cristian
AU  - Andrei AC
AD  - Division of Biostatistics, Northwestern University Feinberg School of Medicine, 
      Chicago, Illinois, USA.
FAU - Pawale, Amit
AU  - Pawale A
AD  - Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular 
      Institute, Northwestern University Feinberg School of Medicine, Chicago, 
      Illinois, USA.
FAU - Ho, Karen J
AU  - Ho KJ
AD  - Division of Vascular Surgery, Department of Surgery, Northwestern University 
      Feinberg School of Medicine, Chicago, Illinois, USA.
FAU - Pham, Duc Thinh
AU  - Pham DT
AD  - Division of Cardiac Surgery, Department of Surgery, Bluhm Cardiovascular 
      Institute, Northwestern University Feinberg School of Medicine, Chicago, 
      Illinois, USA.
LA  - eng
PT  - Journal Article
DEP - 20210621
PL  - United States
TA  - J Card Surg
JT  - Journal of cardiac surgery
JID - 8908809
SB  - IM
MH  - Adult
MH  - Aged
MH  - Ankle Brachial Index
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - Femoral Artery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Perfusion
MH  - Retrospective Studies
OTO - NOTNLM
OT  - cardiovascular research
EDAT- 2021/06/23 06:00
MHDA- 2021/08/12 06:00
CRDT- 2021/06/22 06:48
PHST- 2021/04/02 00:00 [received]
PHST- 2021/05/19 00:00 [accepted]
PHST- 2021/06/23 06:00 [pubmed]
PHST- 2021/08/12 06:00 [medline]
PHST- 2021/06/22 06:48 [entrez]
AID - 10.1111/jocs.15757 [doi]
PST - ppublish
SO  - J Card Surg. 2021 Sep;36(9):3119-3125. doi: 10.1111/jocs.15757. Epub 2021 Jun 21.