Best evidence summary of prevention and management of lower limb ischemia in patients with veno-arterial extracorporeal membrane oxygenation
10.3760/cma.j.cn121430-20240319-00255
- VernacularTitle:静脉-动脉体外膜肺氧合患者下肢缺血预防和管理的最佳证据总结
- Author:
Lihua CHEN
1
;
Xinning WANG
;
Jing WANG
;
Tingting HE
;
Yao HUANG
;
Qingqing SHENG
;
Yufeng TAN
;
Shuqin ZHANG
;
Xiaoqun HUANG
;
Mengmeng XU
;
Ling SANG
;
Jie ZHANG
;
Yonghao XU
Author Information
1. 广州医科大学附属第一医院重症医学科，广东广州 510230
- Keywords:
Extracorporeal membrane oxygenation;
Lower limb ischemia;
Evidence summary;
Evidence-based nursing
- From:
Chinese Critical Care Medicine
2024;36(11):1190-1195
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To provide evidence-based recommendations for the prevention and management of lower limb ischemia in veno-arterial extracorporeal membrane oxygenation (VA-ECMO) patients during treatment according to search, evaluate, and summarize the best evidence on the prevention and management of lower limb ischemia in patients with VA-ECMO.Methods:Based on the PIPOST framework (population, intervention, professional, outcome, setting, and type of evidence), an evidence-based question was formulated. A systematic search was conducted according to the "6S" evidence pyramid model in both domestic and international databases, as well as professional association websites, for all evidence related to the prevention and management of lower limb ischemia in VA-ECMO patients (aged ≥18 years). The types of evidence included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and original studies. The search was conducted from the construction of the databases to February 2024. Two researchers independently conducted a literature quality evaluation, extracted and summarized evidence from the studies that met the quality criteria.Results:A total of 13 articles were included, consisting of 3 clinical decisions, 3 guidelines, 3 expert consensus, 3 systematic reviews, and 1 randomized controlled trial. A total of 18 pieces of evidence in 7 dimensions were summarized, including risk factors of VA-ECMO lower limb ischemia, evaluation before catheterization, evaluation and monitoring during treatment, prevention of lower limb ischemia, treatment of lower limb ischemia, management of distal perfusion catheter (DPC), and monitoring after VA-ECMO weaning.Conclusion:This evidence summary provides evidence-based recommendations for the prevention and management of lower limb ischemia in VA-ECMO patients, aiming to assist clinical healthcare professionals in developing tailored strategies for the prevention and management of lower limb ischemia based on during VA-ECMO support.
