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The following is a summary of “Vascular Complications After Venoarterial Extracorporeal Membrane Oxygenation Support: A CT Study,” published in the November 2024 issue of Critical Care by Djavidi et al. 

Researchers conducted a retrospective study to investigate the frequency, predictors, and management of vascular complications following venoarterial extracorporeal membrane oxygenation (ECMO).  

They analyzed the adults successfully weaned from venoarterial ECMO between January 2021 and January 2022. During this period, 288 individuals received venoarterial ECMO, and of these, 194 were successfully weaned. From this group, 109 individuals underwent CT scans to evaluate vascular complications within 4 days post-weaning. The median age of participants was 58 years (interquartile range [IQR], 46–64 years), with a median ECMO support duration of 7 days (IQR, 5–12 days).  

The results showed that vascular complications occurred in 88 patients (81%). Thrombosis was the most common complication, including cannula-associated deep vein thrombosis (CaDVT) in 63 cases (58%) and arterial thrombosis in 36 cases (33%). Nonthrombotic arterial complications were found in 48 patients (44%), with 35 (31%) presenting bleeding. The inferior vena cava was the most recurring site for CaDVT, seen in 33 cases (50%), while 20% of patients had pulmonary embolism. There was no correlation between thrombotic complications and ECMO duration, anticoagulation levels, or ECMO rotation flow and CT scans impacted management decisions in 83% of cases. The in-hospital mortality rate was 17%, regardless of the presence of vascular complications.  

Investigators concluded that routine CT screening after ECMO decannulation was essential for early detection and management of vascular complications. 

Source: journals.lww.com/ccmjournal/fulltext/9900/vascular_complications_after_venoarterial.400.aspx