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Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations
Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts a...
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| Published in: | Journal of artificial organs 2023-06, Vol.26 (2), p.119-126 |
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| container_end_page | 126 |
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| creator | Smood, Benjamin Fowler, Cody Rao, Sriram D. Genuardi, Michael V. Sperry, Alexandra E. Goel, Nicholas Acker, Andrew M. Olia, Salim E. Iyengar, Amit Han, Jason J. Helmers, Mark R. Patrick, William L. Kelly, John J. Bermudez, Christian Cevasco, Marisa |
| description | Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts analyzed included transplanted patients (TPs) and non-transplanted patients (N-TPs) who did or did not develop ECMO-related subacute groin complications. Standard descriptive statistics were used for comparisons. Logistic regressions identified associated risk factors. Overall, 82/367 (22.3%) ECMO patients developed subacute groin complications, including 25/82 (30.5%) seromas/lymphoceles, 32/82 (39.0%) hematomas, 18/82 (22.0%) infections, and 7/82 (8.5%) non-specified collections. Of these, 20/82 (24.4%) underwent surgical interventions, most of which were muscle flaps (14/20, 70.0%). TPs had a higher incidence of subacute groin complications than N-TPs (14/28, 50.0% vs. 68/339, 20.1%,
P
= 0.001). Seromas/lymphoceles more often developed in TPs than N-TPs (10/14, 71.4% vs. 15/68, 22.1%,
P
= 0.001). Most patients with subacute groin complications survived to discharge (60/68, 88.2%). N-TPs who developed subacute groin complications had longer post-ECMO lengths of stay than those who did not (34 days, IQR 16–53 days vs. 17 days, IQR 8–34 days,
P
|
| doi_str_mv | 10.1007/s10047-022-01342-3 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2681045505</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2681045505</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-3f2dd960d5a0a2f27ed44c99b09ee4f935825740a500a5ca7faa8f50aeaf09dd3</originalsourceid><addsrcrecordid>eNp9kUtLJDEUhcPg4Gv8Ay4k4MZNOTevTmcpjS9QXOisw-0kpZHqSptUMcz8emOX44ALF0ku3O-eG84h5JDBKQPQP0u9pW6A8waYkLwR38gumzHTgAG5VWspZKM5Nztkr5RnAKaVhm2yI5RWTHO2S_z9uEQ3DoE-5hR76tJq3UWHQ0x9oTl0OARPh0TPF7d31GHfj92mSTEHiqUkFzfI7zg80S71jyHTp1TWccAu_p10fpDvLXYlHLy_--TXxfnD4qq5ubu8XpzdNE4YMzSi5d6bGXiFgLzlOngpnTFLMCHI1gg150pLQAX1ONQt4rxVgAFbMN6LfXIy6a5zehlDGewqFhe6DvuQxmL5bM5AKgWqosef0Oc05r7-zvI5Z0LLmeGV4hPlciolh9auc1xh_mMZ2LcM7JSBrRnYTQZW1KGjd-lxuQr-Y-Sf6RUQE1Bq682w_7u_kH0FzmqS7w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2821374692</pqid></control><display><type>article</type><title>Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations</title><source>Springer Nature</source><creator>Smood, Benjamin ; Fowler, Cody ; Rao, Sriram D. ; Genuardi, Michael V. ; Sperry, Alexandra E. ; Goel, Nicholas ; Acker, Andrew M. ; Olia, Salim E. ; Iyengar, Amit ; Han, Jason J. ; Helmers, Mark R. ; Patrick, William L. ; Kelly, John J. ; Bermudez, Christian ; Cevasco, Marisa</creator><creatorcontrib>Smood, Benjamin ; Fowler, Cody ; Rao, Sriram D. ; Genuardi, Michael V. ; Sperry, Alexandra E. ; Goel, Nicholas ; Acker, Andrew M. ; Olia, Salim E. ; Iyengar, Amit ; Han, Jason J. ; Helmers, Mark R. ; Patrick, William L. ; Kelly, John J. ; Bermudez, Christian ; Cevasco, Marisa</creatorcontrib><description>Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts analyzed included transplanted patients (TPs) and non-transplanted patients (N-TPs) who did or did not develop ECMO-related subacute groin complications. Standard descriptive statistics were used for comparisons. Logistic regressions identified associated risk factors. Overall, 82/367 (22.3%) ECMO patients developed subacute groin complications, including 25/82 (30.5%) seromas/lymphoceles, 32/82 (39.0%) hematomas, 18/82 (22.0%) infections, and 7/82 (8.5%) non-specified collections. Of these, 20/82 (24.4%) underwent surgical interventions, most of which were muscle flaps (14/20, 70.0%). TPs had a higher incidence of subacute groin complications than N-TPs (14/28, 50.0% vs. 68/339, 20.1%,
P
= 0.001). Seromas/lymphoceles more often developed in TPs than N-TPs (10/14, 71.4% vs. 15/68, 22.1%,
P
= 0.001). Most patients with subacute groin complications survived to discharge (60/68, 88.2%). N-TPs who developed subacute groin complications had longer post-ECMO lengths of stay than those who did not (34 days, IQR 16–53 days vs. 17 days, IQR 8–34 days,
P
< 0.001). Post-ECMO length of stay was also longer among patients who underwent related surgical interventions compared to those who did not (50 days, IQR 35–67 days vs. 29 days, IQR 16–49 days,
P
= 0.007). Transplantation was the strongest risk factor for developing subacute groin complications (OR 3.91, CI
95%
1.52–10.04,
P
= 0.005). Subacute groin complications and related surgical interventions are common after ECMO cannulation and are associated with longer hospital stays. When surgical management is warranted, muscle flaps may reduce lengths of stay compared to other surgical interventions.</description><identifier>ISSN: 1434-7229</identifier><identifier>EISSN: 1619-0904</identifier><identifier>DOI: 10.1007/s10047-022-01342-3</identifier><identifier>PMID: 35751721</identifier><language>eng</language><publisher>Singapore: Springer Nature Singapore</publisher><subject>Biomedical Engineering and Bioengineering ; Cannulation ; Cardiac Surgery ; Complications ; Extracorporeal membrane oxygenation ; Hematoma ; Medicine ; Medicine & Public Health ; Muscles ; Nephrology ; Original Article ; Oxygenation ; Patients ; Risk factors ; Transplantation</subject><ispartof>Journal of artificial organs, 2023-06, Vol.26 (2), p.119-126</ispartof><rights>The Japanese Society for Artificial Organs 2022</rights><rights>2022. The Japanese Society for Artificial Organs.</rights><rights>The Japanese Society for Artificial Organs 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-3f2dd960d5a0a2f27ed44c99b09ee4f935825740a500a5ca7faa8f50aeaf09dd3</citedby><cites>FETCH-LOGICAL-c399t-3f2dd960d5a0a2f27ed44c99b09ee4f935825740a500a5ca7faa8f50aeaf09dd3</cites><orcidid>0000-0002-8667-6591</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35751721$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smood, Benjamin</creatorcontrib><creatorcontrib>Fowler, Cody</creatorcontrib><creatorcontrib>Rao, Sriram D.</creatorcontrib><creatorcontrib>Genuardi, Michael V.</creatorcontrib><creatorcontrib>Sperry, Alexandra E.</creatorcontrib><creatorcontrib>Goel, Nicholas</creatorcontrib><creatorcontrib>Acker, Andrew M.</creatorcontrib><creatorcontrib>Olia, Salim E.</creatorcontrib><creatorcontrib>Iyengar, Amit</creatorcontrib><creatorcontrib>Han, Jason J.</creatorcontrib><creatorcontrib>Helmers, Mark R.</creatorcontrib><creatorcontrib>Patrick, William L.</creatorcontrib><creatorcontrib>Kelly, John J.</creatorcontrib><creatorcontrib>Bermudez, Christian</creatorcontrib><creatorcontrib>Cevasco, Marisa</creatorcontrib><title>Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations</title><title>Journal of artificial organs</title><addtitle>J Artif Organs</addtitle><addtitle>J Artif Organs</addtitle><description>Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts analyzed included transplanted patients (TPs) and non-transplanted patients (N-TPs) who did or did not develop ECMO-related subacute groin complications. Standard descriptive statistics were used for comparisons. Logistic regressions identified associated risk factors. Overall, 82/367 (22.3%) ECMO patients developed subacute groin complications, including 25/82 (30.5%) seromas/lymphoceles, 32/82 (39.0%) hematomas, 18/82 (22.0%) infections, and 7/82 (8.5%) non-specified collections. Of these, 20/82 (24.4%) underwent surgical interventions, most of which were muscle flaps (14/20, 70.0%). TPs had a higher incidence of subacute groin complications than N-TPs (14/28, 50.0% vs. 68/339, 20.1%,
P
= 0.001). Seromas/lymphoceles more often developed in TPs than N-TPs (10/14, 71.4% vs. 15/68, 22.1%,
P
= 0.001). Most patients with subacute groin complications survived to discharge (60/68, 88.2%). N-TPs who developed subacute groin complications had longer post-ECMO lengths of stay than those who did not (34 days, IQR 16–53 days vs. 17 days, IQR 8–34 days,
P
< 0.001). Post-ECMO length of stay was also longer among patients who underwent related surgical interventions compared to those who did not (50 days, IQR 35–67 days vs. 29 days, IQR 16–49 days,
P
= 0.007). Transplantation was the strongest risk factor for developing subacute groin complications (OR 3.91, CI
95%
1.52–10.04,
P
= 0.005). Subacute groin complications and related surgical interventions are common after ECMO cannulation and are associated with longer hospital stays. When surgical management is warranted, muscle flaps may reduce lengths of stay compared to other surgical interventions.</description><subject>Biomedical Engineering and Bioengineering</subject><subject>Cannulation</subject><subject>Cardiac Surgery</subject><subject>Complications</subject><subject>Extracorporeal membrane oxygenation</subject><subject>Hematoma</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Muscles</subject><subject>Nephrology</subject><subject>Original Article</subject><subject>Oxygenation</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Transplantation</subject><issn>1434-7229</issn><issn>1619-0904</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kUtLJDEUhcPg4Gv8Ay4k4MZNOTevTmcpjS9QXOisw-0kpZHqSptUMcz8emOX44ALF0ku3O-eG84h5JDBKQPQP0u9pW6A8waYkLwR38gumzHTgAG5VWspZKM5Nztkr5RnAKaVhm2yI5RWTHO2S_z9uEQ3DoE-5hR76tJq3UWHQ0x9oTl0OARPh0TPF7d31GHfj92mSTEHiqUkFzfI7zg80S71jyHTp1TWccAu_p10fpDvLXYlHLy_--TXxfnD4qq5ubu8XpzdNE4YMzSi5d6bGXiFgLzlOngpnTFLMCHI1gg150pLQAX1ONQt4rxVgAFbMN6LfXIy6a5zehlDGewqFhe6DvuQxmL5bM5AKgWqosef0Oc05r7-zvI5Z0LLmeGV4hPlciolh9auc1xh_mMZ2LcM7JSBrRnYTQZW1KGjd-lxuQr-Y-Sf6RUQE1Bq682w_7u_kH0FzmqS7w</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Smood, Benjamin</creator><creator>Fowler, Cody</creator><creator>Rao, Sriram D.</creator><creator>Genuardi, Michael V.</creator><creator>Sperry, Alexandra E.</creator><creator>Goel, Nicholas</creator><creator>Acker, Andrew M.</creator><creator>Olia, Salim E.</creator><creator>Iyengar, Amit</creator><creator>Han, Jason J.</creator><creator>Helmers, Mark R.</creator><creator>Patrick, William L.</creator><creator>Kelly, John J.</creator><creator>Bermudez, Christian</creator><creator>Cevasco, Marisa</creator><general>Springer Nature Singapore</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8667-6591</orcidid></search><sort><creationdate>20230601</creationdate><title>Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations</title><author>Smood, Benjamin ; Fowler, Cody ; Rao, Sriram D. ; Genuardi, Michael V. ; Sperry, Alexandra E. ; Goel, Nicholas ; Acker, Andrew M. ; Olia, Salim E. ; Iyengar, Amit ; Han, Jason J. ; Helmers, Mark R. ; Patrick, William L. ; Kelly, John J. ; Bermudez, Christian ; Cevasco, Marisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-3f2dd960d5a0a2f27ed44c99b09ee4f935825740a500a5ca7faa8f50aeaf09dd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Biomedical Engineering and Bioengineering</topic><topic>Cannulation</topic><topic>Cardiac Surgery</topic><topic>Complications</topic><topic>Extracorporeal membrane oxygenation</topic><topic>Hematoma</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Muscles</topic><topic>Nephrology</topic><topic>Original Article</topic><topic>Oxygenation</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smood, Benjamin</creatorcontrib><creatorcontrib>Fowler, Cody</creatorcontrib><creatorcontrib>Rao, Sriram D.</creatorcontrib><creatorcontrib>Genuardi, Michael V.</creatorcontrib><creatorcontrib>Sperry, Alexandra E.</creatorcontrib><creatorcontrib>Goel, Nicholas</creatorcontrib><creatorcontrib>Acker, Andrew M.</creatorcontrib><creatorcontrib>Olia, Salim E.</creatorcontrib><creatorcontrib>Iyengar, Amit</creatorcontrib><creatorcontrib>Han, Jason J.</creatorcontrib><creatorcontrib>Helmers, Mark R.</creatorcontrib><creatorcontrib>Patrick, William L.</creatorcontrib><creatorcontrib>Kelly, John J.</creatorcontrib><creatorcontrib>Bermudez, Christian</creatorcontrib><creatorcontrib>Cevasco, Marisa</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of artificial organs</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smood, Benjamin</au><au>Fowler, Cody</au><au>Rao, Sriram D.</au><au>Genuardi, Michael V.</au><au>Sperry, Alexandra E.</au><au>Goel, Nicholas</au><au>Acker, Andrew M.</au><au>Olia, Salim E.</au><au>Iyengar, Amit</au><au>Han, Jason J.</au><au>Helmers, Mark R.</au><au>Patrick, William L.</au><au>Kelly, John J.</au><au>Bermudez, Christian</au><au>Cevasco, Marisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations</atitle><jtitle>Journal of artificial organs</jtitle><stitle>J Artif Organs</stitle><addtitle>J Artif Organs</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>26</volume><issue>2</issue><spage>119</spage><epage>126</epage><pages>119-126</pages><issn>1434-7229</issn><eissn>1619-0904</eissn><abstract>Subacute groin complications associated with extracorporeal membrane oxygenation (ECMO) cannulation are well recognized, yet their effects on clinical outcomes remain unknown. This single-center, retrospective study reviewed all patients receiving venoarterial ECMO from 01/2017 to 02/2020. Cohorts analyzed included transplanted patients (TPs) and non-transplanted patients (N-TPs) who did or did not develop ECMO-related subacute groin complications. Standard descriptive statistics were used for comparisons. Logistic regressions identified associated risk factors. Overall, 82/367 (22.3%) ECMO patients developed subacute groin complications, including 25/82 (30.5%) seromas/lymphoceles, 32/82 (39.0%) hematomas, 18/82 (22.0%) infections, and 7/82 (8.5%) non-specified collections. Of these, 20/82 (24.4%) underwent surgical interventions, most of which were muscle flaps (14/20, 70.0%). TPs had a higher incidence of subacute groin complications than N-TPs (14/28, 50.0% vs. 68/339, 20.1%,
P
= 0.001). Seromas/lymphoceles more often developed in TPs than N-TPs (10/14, 71.4% vs. 15/68, 22.1%,
P
= 0.001). Most patients with subacute groin complications survived to discharge (60/68, 88.2%). N-TPs who developed subacute groin complications had longer post-ECMO lengths of stay than those who did not (34 days, IQR 16–53 days vs. 17 days, IQR 8–34 days,
P
< 0.001). Post-ECMO length of stay was also longer among patients who underwent related surgical interventions compared to those who did not (50 days, IQR 35–67 days vs. 29 days, IQR 16–49 days,
P
= 0.007). Transplantation was the strongest risk factor for developing subacute groin complications (OR 3.91, CI
95%
1.52–10.04,
P
= 0.005). Subacute groin complications and related surgical interventions are common after ECMO cannulation and are associated with longer hospital stays. When surgical management is warranted, muscle flaps may reduce lengths of stay compared to other surgical interventions.</abstract><cop>Singapore</cop><pub>Springer Nature Singapore</pub><pmid>35751721</pmid><doi>10.1007/s10047-022-01342-3</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8667-6591</orcidid></addata></record> |
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| subjects | Biomedical Engineering and Bioengineering Cannulation Cardiac Surgery Complications Extracorporeal membrane oxygenation Hematoma Medicine Medicine & Public Health Muscles Nephrology Original Article Oxygenation Patients Risk factors Transplantation |
| title | Subacute groin complications related to ECMO cannulation are associated with longer hospitalizations |
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