The following is a summary of “Percutaneous cannulation is associated with lower rate of severe neurological complication in femoro-femoral ECPR: results from the Extracorporeal Life Support Organization Registry,” published in the August 2023 issue of Critical Care by Wang et al.

Percutaneous cannulation is now the preferred approach for extracorporeal membrane oxygenation (ECPR) in adults, but studies have been restricted by small sample sizes and single-center settings. Researchers performed a retrospective study to compare in-hospital outcomes in cardiac arrest (CA) patients who received femoro-femoral ECPR with percutaneous versus surgical cannulation.

They extracted data from the international Extracorporeal Life Support Organization registry for adults with refractory CA who underwent either percutaneous or surgical femoro-femoral ECPR between January 2008 and December 2019. The primary outcome was severe neurological complications. Multivariable logistic regression assessed the association between percutaneous cannulation and in-hospital outcomes.

The results showed that of 3,575 patients, 2,749 (77%) underwent percutaneous cannulation. The proportion of patients undergoing percutaneous cannulation surged significantly from 18% to 89% (P<0.001). Severe neurological complications occurred less frequently in the percutaneous group compared to the surgical group (13% vs. 19%, P<0.001). In adjusted analyses, percutaneous cannulation was freely linked with a lower rate of severe neurological complications ( OR 0.62; 95% CI 0.46–0.83; P=0.002), while in-hospital mortality, limb ischemia, and cannulation site bleeding rates were the same between the two groups (P>0.05). Outcome consistency was observed regardless of center percutaneous experience or center ECPR volume.

They concluded percutaneous cannulation was associated with a lower rate of severe neurological complications in ECPR.

Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01174-1