Comparing Early Versus Delayed Distal Perfusion to Prevent Limb Ischemia in Patients Receiving Peripheral Venoarterial ECMO for Cardiogenic Shock

What this Trial Is About

Researchers are evaluating the timing of distal perfusion catheterization DPC to prevent limb ischemia in patients receiving peripheral venoarterial extracorporeal membrane oxygenation VA-ECMO for refractory cardiogenic shock. Large cannulas used in the femoral artery and vein during VA-ECMO can cause peripheral limb ischemia. This study compares outcomes between an early DPC approach done within 1 hour after VA-ECMO application and a conventional approach where DPC is performed only when signs of limb ischemia appear. Participants are randomly assigned to one of two groups the preemptive DPC group receives catheterization within an hour of VA-ECMO start, while the conventional group receives catheterization only after limb ischemia signs develop. The study assesses the effect of these timing strategies on limb ischemia and other complications during ECMO support. During the study, researchers monitor participants for limb ischemia from randomization until discharge or up to 90 days. They also track all-cause mortality for up to 12 months, successful ECMO weaning, and ECMO-related complications. The trial involves ongoing clinical assessments to evaluate safety and effectiveness of the two catheterization timing approaches in patients undergoing VA-ECMO for cardiogenic shock.

Distal Perfusion Timing, Early or Conservative, to Prevent Limb Ischemia During Peripheral VA-ECMO