Near-Infrared Spectroscopy Monitoring for Early Detection of Limb Ischemia in Patients on Veno-Arterial Extracorporeal Membrane Oxygenation

This study aimed to investigate the effectiveness of near-infrared spectroscopy (NIRS) monitoring for the early detection of limb ischemia in patients who were placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) via femoral artery. We prospectively used NIRS monitoring for the early detection of limb ischemia in 28 adult patients, who were supported with peripheral VA-ECMO between August 2013 and August 2014 (NIRS group). A decision to perform distal perfusion catheterization was made in accordance with the regional oxygen saturation (rSO 2 ) values provided by the NIRS system. For the comparison of outcome, the medical records of 36 adult patients who had been previously supported with peripheral VA-ECMO without NIRS monitoring (Control group), between July 2012 and July 2013, were retrospectively reviewed. There was no significant difference between the frequency of distal perfusion in both groups ( p = 0.435). The mean time to distal perfusion is shorter in the NIRS group (19.6 ± 21.4 vs . 42.0 ± 69.0 hours). No patient underwent fasciotomy in the NIRS group, while 13.9% did in the control group ( p = 0.040). We think that NIRS monitoring is a useful and reliable method for the early detection of limb ischemia in patients undergoing peripheral VA-ECMO. Its application may allow timely correction of perfusion deficits and the prevention of compartment syndrome and limb complications.