Cardiac arrest & resuscitation
Risk of Developing Lower Limb Ischemia in Patients With Extracorporeal Cardiopulmonary Resuscitation: A Secondary Analysis of the Study of Advanced Cardiac Life Support for Ventricular Fibrillation With Extracorporeal Circulation in Japan II (SAVE-J II) Study
Authors' conclusion
Lower limb ischemia during ECPR would be anticipated in patients with cannulation-related complications
Study context
- Population
- Adults who underwent extracorporeal cardiopulmonary resuscitation (ECPR) for OHCA, 36 Japanese institutions, 2013–2018
- Participants
- 969 adults · 36 institutions
- Comparison
- Patients with vs without lower limb ischemia during ECPR
- Limb ischemian = 72
- Primary endpoint
- Lower limb ischemia (requirement for therapeutic DPC, fasciotomy or amputation) and its risk factors
Methodological detailspost hoc analysis, nationwide, multicentre
- Post hoc analysis
- Nationwide
- Multicentre
Primary result
As reported in the abstract
Incidence of lower limb ischemia
Limb ischemia
7.4%
72
Further findings
Prophylactic DPC use
P < 0.001
Cannulation-related bleeding
P = 0.009
Cannula malposition
P < 0.001
| Outcome | Estimate | P value |
|---|---|---|
| Risk factors for lower limb ischemia (multivariable analysis)Prophylactic DPC placement · lower risk · multivariate logistic regression | 0.20 (CI 0.07–0.55) | P = 0.002 |
| Risk factors for lower limb ischemia (multivariable analysis)Cannulation-related bleeding · increased risk · multivariate logistic regression | 1.83 (CI 1.06–3.14) | P = 0.030 |
| Risk factors for lower limb ischemia (multivariable analysis)Cannula malposition · increased risk · multivariate logistic regression | 3.81 (CI 1.68–8.64) | P = 0.001 |
Background characteristics, cannulation location, puncture method, VA extracorporeal membrane oxygenation (ECMO) catheter size
- No significant differences between patients with and without limb ischemia
Original publication
Risk of Developing Lower Limb Ischemia in Patients With Extracorporeal Cardiopulmonary Resuscitation: A Secondary Analysis of the Study of Advanced Cardiac Life Support for Ventricular Fibrillation With Extracorporeal Circulation in Japan II (SAVE-J II) Study. Crit Care Med. Published 30 December 2025. doi:10.
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