Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations

被引：5

作者：

Smood, Benjamin ^{[1
]}

Fowler, Cody ^{[2
]}

Rao, Sriram D. ^{[2
]}

Genuardi, Michael V. ^{[2
]}

Sperry, Alexandra E. ^{[2
]}

Goel, Nicholas ^{[1
]}

Acker, Andrew M. ^{[1
]}

Olia, Salim E. ^{[1
]}

Iyengar, Amit ^{[1
]}

Han, Jason J. ^{[1
]}

Helmers, Mark R. ^{[1
]}

Patrick, William L. ^{[1
]}

Kelly, John J. ^{[1
]}

Bermudez, Christian ^{[1
]}

Cevasco, Marisa ^{[1
]}

机构：

[1] Hosp Univ Penn, Div Cardiovasc Surg, Dept Surg, 3400 Spruce St,6, Philadelphia, PA 19104 USA

[2] Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA

来源：

JOURNAL OF ARTIFICIAL ORGANS | 2023年 / 26卷 / 02期

关键词：

ECMO; Extracorporeal membrane oxygenation; ECPR; Groin complications; Transplant; EXTRACORPOREAL MEMBRANE-OXYGENATION; CARDIOGENIC-SHOCK;

D O I：

10.1007/s10047-022-01342-3

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts analyzed included transplanted patients (TPs) and non-transplanted patients (N-TPs) who did or did not develop ECMO-related subacute groin complications. Standard descriptive statistics were used for comparisons. Logistic regressions identified associated risk factors. Overall, 82/367 (22.3%) ECMO patients developed subacute groin complications, including 25/82 (30.5%) seromas/lymphoceles, 32/82 (39.0%) hematomas, 18/82 (22.0%) infections, and 7/82 (8.5%) non-specified collections. Of these, 20/82 (24.4%) underwent surgical interventions, most of which were muscle flaps (14/20, 70.0%). TPs had a higher incidence of subacute groin complications than N-TPs (14/28, 50.0% vs. 68/339, 20.1%, P = 0.001). Seromas/lymphoceles more often developed in TPs than N-TPs (10/14, 71.4% vs. 15/68, 22.1%, P = 0.001). Most patients with subacute groin complications survived to discharge (60/68, 88.2%). N-TPs who developed subacute groin complications had longer post-ECMO lengths of stay than those who did not (34 days, IQR 16-53 days vs. 17 days, IQR 8-34 days, P < 0.001). Post-ECMO length of stay was also longer among patients who underwent related surgical interventions compared to those who did not (50 days, IQR 35-67 days vs. 29 days, IQR 16-49 days, P = 0.007). Transplantation was the strongest risk factor for developing subacute groin complications (OR 3.91, CI95% 1.52-10.04, P = 0.005). Subacute groin complications and related surgical interventions are common after ECMO cannulation and are associated with longer hospital stays. When surgical management is warranted, muscle flaps may reduce lengths of stay compared to other surgical interventions.

引用

页码：119 / 126

页数：8

共 50 条

[1] Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations
Benjamin Smood
Cody Fowler
Sriram D. Rao
Michael V. Genuardi
Alexandra E. Sperry
Nicholas Goel
Andrew M. Acker
Salim E. Olia
Amit Iyengar
Jason J. Han
Mark R. Helmers
William L. Patrick
John J. Kelly
Christian Bermudez
Marisa Cevasco
Journal of Artificial Organs, 2023, 26 : 119 - 126
[2] ECMO Cannulation Controversies and Complications
Stulak, John M.
Dearani, Joseph A.
Burkhart, Harold M.
Barnes, Roxann D.
Scott, Phillip D.
Schears, Gregory J.
SEMINARS IN CARDIOTHORACIC AND VASCULAR ANESTHESIA, 2009, 13 (03) : 176 - 182
[3] Percutaneous cannulation for cardiopulmonary bypass in minimally invasive surgery is associated with reduced groin complications
Moschovas, Alexandros
Amorim, Paulo A.
Nold, Mariana
Faerber, Gloria
Diab, Mahmoud
Buenger, Tobias
Doenst, Torsten
INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, 2017, 25 (03) : 377 - 383
[4] CIRCULATORY SUPPORT BY VA ECMO (VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION): CANNULATION TYPES AND RELATED COMPLICATIONS
Solla Buceta, M. A.
Hurtado Doce, A. I.
Garcia Monge, M. J.
Seoane Quiroga, L.
INTENSIVE CARE MEDICINE, 2013, 39 : S302 - S303
[5] OCCURENCE OF COMPLICATIONS IN PERCUTANEOUS VA AND VV ECMO CANNULATION PERFORMED BY THE INTENSIVIST
Orija, Abiodun
El Banayosy, Aly
Koerner, Michael
CRITICAL CARE MEDICINE, 2016, 44 (12)
[6] Ileal cannulation and associated complications in dogs
Hill, RC
Ellison, GW
Burrows, CF
Bauer, JE
Carbia, B
LABORATORY ANIMAL SCIENCE, 1996, 46 (01): : 77 - 80
[7] COMPLICATIONS ASSOCIATED WITH CENTRAL VENOUS CANNULATION
DAWOOD, MM
TREBBIN, WM
HOSPITAL PRACTICE, 1991, 26 (06): : 211 - &
[8] Measles-related hospitalizations and associated complications in Jerusalem, 2018-2019
Ben-Chetrit, E.
Oster, Y.
Jarjou'i, A.
Megged, O.
Lachish, T.
Cohen, M. J.
Stein-Zamir, C.
Ivgi, H.
Rivkin, M.
Milgrom, Y.
Averbuch, D.
Korem, M.
Wolf, D. G.
Wiener-Well, Y.
CLINICAL MICROBIOLOGY AND INFECTION, 2020, 26 (05) : 637 - 642
[9] Percutaneous cannulation for cardiopulmonary bypass in robotic mitral valve surgery with zero groin complications
Bastopcu, Murat
Senay, Sahin
Gullu, Ahmet U.
Kocyigit, Muharrem
Alhan, Cem
JOURNAL OF CARDIAC SURGERY, 2022, 37 (02) : 280 - 284
[10] BILATERAL THORACIC DUCT CANNULATION - ASSOCIATED COMPLICATIONS
FALOR, WH
KELLY, TR
BOECKMAN, CR
ARCHIVES OF SURGERY, 1964, 88 (05) : 787 - 792

← 1 2 3 4 5 →