• Dirk Lunz, Alois Philipp, Thomas Müller, Karin Pfister, Maik Foltan, Leopold Rupprecht, Christof Schmid, Matthias Lubnow, Bernhard Graf, and Barbara Sinner.
• Department of Anesthesiology, University Medical Center Regensburg, Franz Josef Strauss Allee 11, 93053 Regensburg, Germany. Electronic address: Dirk.Lunz@ukr.de.
• J Crit Care. 2019 Aug 1; 52: 58-62.

PurposeVenoarterial (VA) ECMO is widely accepted as salvage therapy for cardio-respiratory or cardiac failure. Vascular complications from cannulation are common and potentially life-threatening. Here, we retrospectively analyzed vascular complications following VA ECMO therapy.Material And MethodsPatients treated with VA ECMO via femoral cannulation from 2010 to 2016 were enrolled. Patient factors, indication and procedure were retrieved from our hospital database and statistically analyzed.Results223 patients were enrolled. Survival rate was 43, 0%. Ischemic vascular complications were seen in 43, 9%. Main manifestation (82, 7%) was stenosis or occlusion of the femoral (common and superficial) or the external iliacal artery. Embolus or dissection occurred in 4, 1%. 32, 7% patients with ischemia required surgical intervention with 24,5% suffering from compartment syndrome. An antegrade perfusion catheter was established in 50% of the patients. Patients receiving VA ECMO for extracorporeal cardiopulmonary resuscitation had the lowest ischemic rates with 28,6%. Multiple regression analysis identified only the underlying indication and the size of the cannula as significant risk factor for vascular complications. Survival rates to hospital discharge were 37,3% and 47,2% in patients with and without ischemic complications.ConclusionsCannula size and indication setting are the most important factors for the development of ischemic complications following VA ECMO.Copyright © 2019 Elsevier Inc. All rights reserved.

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