A review of regional limb perfusion for distal limb infections in the horse

2020 ◽  
Author(s):  
S. A. Biasutti ◽  
E. Cox ◽  
L. B. Jeffcott ◽  
A. J. Dart
Keyword(s):  
Distal Limb ◽  
Limb Perfusion

A Simple Technique of Distal Limb Perfusion During Prolonged Femoro-Femoral Cannulation

2006 ◽  
Vol 21 (2) ◽  
pp. 168-169 ◽  
Author(s):  
Navid Madershahian ◽  
Ragi Nagib ◽  
Jens Wippermann ◽  
Justus Strauch ◽  
Thorsten Wahlers
Keyword(s):  
Simple Technique ◽  
Distal Limb ◽  
Limb Perfusion

scholarly journals Risk factors for critical limb ischemia in patients undergoing femoral cannulation for venoarterial extracorporeal membrane oxygenation: Is distal limb perfusion a mandatory approach?

Perfusion ◽  
2019 ◽  
Vol 34 (6) ◽  
pp. 453-459 ◽  
Author(s):  
Tim Kaufeld ◽  
Eric Beckmann ◽  
Fabio Ius ◽  
Nurbol Koigeldiev ◽  
Wiebke Sommer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Extracorporeal Membrane Oxygenation ◽  
Limb Ischemia ◽  
Distal Limb ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Limb Perfusion ◽  
Group A ◽  
Group B

Background: Venoarterial extracorporeal membrane oxygenation support is a well-established tool in the care of severe refractory cardiac and respiratory failure. The application of this support may serve as a bridge to transplant, recovery or to implantation of a ventricular assist device. Venoarterial extracorporeal membrane oxygenation support can be administered through an open surgical access via the common femoral or axillary artery or a percutaneous approach using Seldinger technique. Both techniques may obstruct the blood flow to the lower limb and may cause a significant ischemia with possible limb loss. Malperfusion of the distal limb can be avoided using an ipsilateral distal limb perfusion, which may be established by adding a single-lumen catheter during venoarterial extracorporeal membrane oxygenation treatment to overcome the obstruction. The aim of this study is to distinguish the presence or absence of a distal limb perfusion regarding the incidence of distal limb ischemia. Furthermore, expected risk factors of open and percutaneous femoral venoarterial extracorporeal membrane oxygenation installation were evaluated for the development of distal limb ischemia. Methods: Between January 2012 and September 2015, 489 patients received venoarterial extracorporeal membrane oxygenation support at our institution. In total, 307 patients (204 male, 103 female) with femoral cannulation were included in the analysis. The cohort was distinguished by the presence (group A; n = 237) or absence (group B; n = 70) of a distal limb perfusion during peripheral venoarterial extracorporeal membrane oxygenation treatment. Furthermore, a risk factor analysis for the development of distal limb ischemia was performed. Results: The main indications for venoarterial extracorporeal membrane oxygenation therapy were a low cardiac output syndrome (LCOS) (53%) and failed weaning of extracorporeal circulation (23%). A total of 23 patients (7.49%) under venoarterial extracorporeal membrane oxygenation support developed severe distal limb malperfusion (3.38% in group A vs 21.42% in group B). Preemptive installation of distal limb perfusion extended the intervention-free intervals to 7.8 ± 19.3 days in group A and 6.3 ± 12.5 in group B. A missing distal limb perfusion (p = 0.001) was identified as a main risk factor for critical limb ischemia. Other comorbidities such as arterial occlusion disease (p = 0.738) were not statistically significantly associated. Surgical intervention due to vascular complications after extracorporeal membrane oxygenation explantation was needed in 14 cases (4.22% in group A and 5.71% in group B). Conclusion: We were able to identify the absence of distal limb perfusion as an independent risk factor for the development of critical distal limb ischemia during femoral venoarterial extracorporeal membrane oxygenation treatment. The application of a distal limb perfusion should be considered as a mandatory approach in the context of femoral venoarterial extracorporeal membrane oxygenation treatment regardless of the implantation technique.

scholarly journals Circumferential constriction ischaemic syndrome (CCIS): A potentially reversible ischaemic condition of lower limb

2019 ◽  
Vol 27 (1) ◽  
pp. 85-88
Author(s):  
Chris Yuk Kwan Tang ◽  
Ng Ka Ho ◽  
Nicola Ho ◽  
Yuki Kwok
Keyword(s):  
Lower Limb ◽  
Wound Dressing ◽  
Treatment Protocol ◽  
Rubber Band ◽  
Flow Chart ◽  
Limb Ischaemia ◽  
Distal Limb ◽  
Comprehensive Management ◽  
Limb Perfusion ◽  
Reversible Condition

Circumferential constriction in limb will lead to distal limb ischaemia. This is a potentially reversible condition but it has a drastic consequence if undiagnosed. We described a patient with underlying diabetes mellitus presented with persistent lower limb linear circumferential ulcer and developing subacute limb ischaemia distal to the ulcer. During further wound dressing, a rubber band was detected in the wound. Surgical exploration removed the rubber band and its circumferential constriction effect. As a result, the ulcer healed uneventfully and the distal limb perfusion improved clinically. A scoring index consisted of contributing risk factors was proposed to facilitate the diagnosis. A flow chart was proposed to serve as a treatment protocol to ensure logical and comprehensive management. We hope the proposal of the new term and flow chart can help improve the threshold of recognition and for salvage of potentially devastating limb ischaemia.

Vascular phase scintigraphic evaluation of equine distal limb perfusion following trauma: 3 cases

1995 ◽  
Vol 27 (3) ◽  
pp. 228-233 ◽  
Author(s):  
B. T. L. BELL ◽  
M. T. LONG ◽  
M. D. CHAMBERS ◽  
G. J. BAKER
Keyword(s):  
Distal Limb ◽  
Limb Perfusion

Distal limb perfusion cannula in peripheral extracorporeal membrane oxygenation: always a mandatory approach?

Perfusion ◽  
2019 ◽  
Vol 34 (6) ◽  
pp. 528-529 ◽  
Author(s):  
Francesco Formica ◽  
Stefano D’Alessandro ◽  
Fabio Sangalli ◽  
Leonello Avalli
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Distal Limb ◽  
Membrane Oxygenation ◽  
Limb Perfusion

Distal Limb Perfusion: Achilles' Heel in Peripheral Venoarterial Extracorporeal Membrane Oxygenation

2014 ◽  
Vol 38 (11) ◽  
pp. 940-944 ◽  
Author(s):  
Prashant N. Mohite ◽  
Javid Fatullayev ◽  
Olaf Maunz ◽  
Sundip Kaul ◽  
Anton Sabashnikov ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Distal Limb ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Limb Perfusion
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