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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Intensive Care Cardiovascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1522789
This article is part of the Research Topic Critical Care Cardiology for Cardiovascular Emergencies View all 9 articles

Feasibility of the Area Reduction Post-closure Technique for Bedside Weaning of Veno-arterial Extracorporeal Membrane Oxygenation

Provisionally accepted
Chen Xu Chen Xu Guo-Xiong Xu Guo-Xiong Xu Yi-Fei Cao Yi-Fei Cao Lei Chen Lei Chen Yi-qi Jin Yi-qi Jin *
  • Suzhou Municipal Hospital, Suzhou, China

The final, formatted version of the article will be published soon.

    Objective: To evaluate the safety and efficacy of the area reduction post-closure technique for bedside weaning of veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Methods: A retrospective study was conducted from December 2022 to November 2023, analyzing data from patients who underwent V-A ECMO weaning at our center. The area reduction post-closure technique, utilizing two ProGlide devices (Abbott Vascular, Santa Clara, CA), was adopted as a standard practice. The technical success was defined as achieving complete hemostasis without a bailout open repair. The complications associated with access included hemorrhagic events, pseudoaneurysm formation, limb ischemia, distal embolization, and wound infections. Results: A total of eighteen patients were included. The median age of the cohort was 72.0 years (interquartile range [IQR], 57.5-81.5 years), with a male-to-female ratio of 2:1. The median size of arterial sheath utilized was 18.0 Fr (IQR, 17.0-20.0 Fr). The median duration of the procedure was 10.0 min (IQR, 9.0-13.0 min), and the median length of total hospital stay was 31.0 days (IQR, 25.5-39.0 days). Furthermore, the technique demonstrated a success rate of 100%. One patient (5.6%) experienced minor bleeding, which was successfully managed through compression. No additional complications associated with access were observed after the procedure. Conclusions: The post-closure area reduction technique emerges as a viable option for bedside weaning of V-A ECMO. Nonetheless, it is essential that this technique be validated through larger comparative studies.

    Keywords: the area reduction post-closure technique, bedside weaning, Veno-arterial extracorporeal membrane oxygenation, Proglide devices, access bleeding

    Received: 05 Nov 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Xu, Xu, Cao, Chen and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Yi-qi Jin, Suzhou Municipal Hospital, Suzhou, China

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