Ambulation With Femoral Arterial Cannulation Can Be Safely Performed on Venoarterial Extracorporeal Membrane Oxygenation

Authors

Chetan Pasrija, University of Maryland School of Medicine
Kristen M. Mackowick, University of Maryland School of Medicine
Maxwell Raithel, University of Maryland School of Medicine
Douglas Tran, University of Maryland School of Medicine
Francesca M. Boulos, University of Maryland School of Medicine
Kristopher B. Deatrick, University of Maryland School of Medicine
Michael A. Mazzeffi, University of Maryland School of Medicine
Raymond Rector, University of Maryland Medical Center
Si M. Pham, Mayo Clinic in Jacksonville, Florida
Bartley P. Griffith, University of Maryland School of Medicine
Daniel L. Herr, University of Maryland School of Medicine
Zachary N. Kon, NYU Langone Health

Document Type

Journal Article

Publication Date

5-1-2019

Journal

Annals of Thoracic Surgery

Volume

107

Issue

5

DOI

10.1016/j.athoracsur.2018.10.048

Abstract

Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support can be associated with significant deconditioning due to the requirement for strict bedrest as a result of femoral arterial cannulation. To address this issue, we evaluated our experience with ambulation in patients with peripheral femoral cannulation for VA-ECMO. Methods: All patients that were peripherally cannulated for VA-ECMO over a 2-year period were retrospectively reviewed. Patients that ambulated at least once while supported with VA-ECMO were included in the analysis. The primary outcomes were safety and feasibility of ambulation, defined as the absence of major bleeding, vascular, or decannulation events. Results: Of 104 patients placed on VA-ECMO, 15 ambulated with a femoral arterial cannula. Forty-six percent of patients were placed on VA-ECMO for decompensated heart failure, and 54% for massive pulmonary embolism. Twenty-seven percent of patients were cannulated during active cardiopulmonary resuscitation. The median length of time from cannulation to out of bed was 3 (range, 0 to 26) days. The median length of time from cannulation to initial ambulation was 4 (range, 1 to 42) days. The median distance of the first postcannulation walk was 300 feet. Neither flow nor speed decreased during or after ambulation. There were no major bleeding events, vascular complications, or decannulation events associated with ambulation. The median intensive care unit length of stay and hospital length of stay were 12 and 21 days, respectively. One-year survival was 100% for ambulating patients. Conclusions: Ambulating patients supported with VA-ECMO, despite femoral arterial cannulation, appears feasible and safe in carefully selected patients.

APA Citation

Pasrija, C., Mackowick, K., Raithel, M., Tran, D., Boulos, F., Deatrick, K., Mazzeffi, M., Rector, R., Pham, S., Griffith, B., Herr, D., & Kon, Z. (2019). Ambulation With Femoral Arterial Cannulation Can Be Safely Performed on Venoarterial Extracorporeal Membrane Oxygenation. Annals of Thoracic Surgery, 107 (5). http://dx.doi.org/10.1016/j.athoracsur.2018.10.048