PMID- 38446827
OWN - NLM
STAT- Publisher
LR  - 20240306
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
DP  - 2024 Mar 5
TI  - Does Size Matter? The Effect of Size of Distal Perfusion Catheter on Acute Limb 
      Ischemia: A Meta-Analysis.
LID - 10.1097/MAT.0000000000002178 [doi]
AB  - Prevention of limb ischemia in patients with venoarterial extracorporeal membrane 
      oxygenation (VA-ECMO) is primarily achieved through the use of distal perfusion 
      catheters (DPC). Our objective was to assess the role of DPC, and specifically 
      the size of the catheter, in reducing the incidence of acute limb ischemia (ALI) 
      through a meta-analysis. Seventeen studies met criteria for analysis. Pooled 
      analysis included a total of 2,040 patients, of which 904 patients received ECMO 
      with DPC and 1,136 patients underwent ECMO without DPC. Compared with ECMO alone, 
      ECMO with DPC, regardless of size, significantly decreased ALI (relative risk 
      [RR]: 0.49, 95% confidence interval [CI]: 0.31-0.77; p = 0.002). When comparing 
      reactive versus prophylactic placement of DPC, prophylactic DPC was associated 
      with significantly decreased ALI (RR: 0.41, 95% CI: 0.24-0.71; p = 0.02). No 
      differences in mortality (RR: 0.89, 95% CI: 0.76-1.03; p = 0.12) and bleeding 
      events (RR: 1.43, 95% CI: 0.41-4.96; p = 0.58) were observed between the two 
      groups. This analysis demonstrates that the placement of DPC, if done 
      prophylactically and regardless of size, is associated with a reduced risk of ALI 
      versus the absence of DPC placement, but is not associated with differences in 
      mortality or bleeding events.
CI  - Copyright (c) ASAIO 2024.
FAU - Gouchoe, Doug A
AU  - Gouchoe DA
AUID- ORCID: 0000-0002-3177-4637
AD  - From the Division of Cardiac Surgery, Department of Surgery, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Chaurasia, Sameer
AU  - Chaurasia S
AD  - Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio.
FAU - Henn, Matthew C
AU  - Henn MC
AD  - From the Division of Cardiac Surgery, Department of Surgery, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Whitson, Bryan A
AU  - Whitson BA
AD  - From the Division of Cardiac Surgery, Department of Surgery, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Mokadam, Nahush A
AU  - Mokadam NA
AD  - From the Division of Cardiac Surgery, Department of Surgery, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Mast, David
AU  - Mast D
AD  - From the Division of Cardiac Surgery, Department of Surgery, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Satyapriya, Sree
AU  - Satyapriya S
AD  - Division of Critical Care Medicine, Department of Anesthesiology, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Vallakati, Ajay
AU  - Vallakati A
AD  - Division of Cardiovascular Medicine, Department of Medicine, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
FAU - Ganapathi, Asvin M
AU  - Ganapathi AM
AUID- ORCID: 0000-0003-2765-3733
AD  - From the Division of Cardiac Surgery, Department of Surgery, The Ohio State 
      University Wexner Medical Center, Columbus, Ohio.
LA  - eng
PT  - Journal Article
DEP - 20240305
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
COIS- Disclosure: B.A.W. serves as a consultant for Abbott Laboratories and serves on 
      the Clinical Events Committee of TransMedics OCS. B.A.W. partially supported 
      through National Institutes of Health (NIH) National Heart Lung and Blood 
      Institute grant R01HL143000. N.A.M. serves and a consultant and investigator for 
      Abbott, Medtronic, Carmat, Xylocor and SynCardia. A.M.G. was a prior consultant 
      for Abbvie Pharmaceuticals. The other authors have no conflicts of interest to 
      report.
EDAT- 2024/03/06 18:42
MHDA- 2024/03/06 18:42
CRDT- 2024/03/06 13:44
PHST- 2024/03/06 18:42 [medline]
PHST- 2024/03/06 18:42 [pubmed]
PHST- 2024/03/06 13:44 [entrez]
AID - 00002480-990000000-00431 [pii]
AID - 10.1097/MAT.0000000000002178 [doi]
PST - aheadofprint
SO  - ASAIO J. 2024 Mar 5. doi: 10.1097/MAT.0000000000002178.