{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:32:26Z","timestamp":1777915946387,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Extracorporeal membrane oxygenation cannulation strategies vary between adults and children. Femoral approach is common in adults and extremity morbidity is well-documented. Aside from limb ischemia, complications in children are theorized and have yet to be studied. This study aims to comprehensively evaluate implications of pediatric femoral cannulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a single-center retrospective review of children &lt;21\u00a0years, undergoing femoral venoarterial (VA) or venovenous (VV) cannulation between 2015 and 2022. The primary outcome was incidence of lower extremity complications on ECMO (groin hematoma\/hemorrhage, vascular thrombosis, North-South syndrome, compartment syndrome, limb loss). Secondary outcome was incidence of post-decannulation extremity complications (pseudoaneurysm, surgical site infection, vascular thrombosis, motor\/sensory deficits).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>29 children were cannulated via femoral approach. Most required VA support (89%). Common sites were right femoral artery (70.8%) and right femoral vein (56%). 18 patients (75%) had distal reperfusion cannulas (DPC) placed. Short-term lower extremity complication rate was 59%, most frequently groin hematoma\/hemorrhage (30%) and North-South syndrome (19%). Compartment syndrome occurred in 3 patients (11%), though none suffered digit\/limb loss. There were no significant differences in complications between cannulation approach (open vs percutaneous) or vessel laterality (ipsilateral vs contralateral). Of those decannulated ( n = 15), median ECMO duration was 8\u00a0days. Following decannulation, 20% suffered pseudoaneurysm. Ten (63%) experienced ipsilateral motor weakness which resolved in 50% of patients at 1-month follow-up; 20% suffered sensory deficits all resolving by discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Approximately one third of children who underwent femoral cannulation suffered groin hematoma\/hemorrhage and nearly 20% experienced North-South syndrome. Following decannulation, most had extremity weakness while sensory deficits were rarer. This marked risk of extremity morbidity prompts proactive inpatient monitoring and close surveillance after discharge.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591231216326","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T19:32:18Z","timestamp":1700249538000},"page":"1692-1699","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Lower extremity complications in children following femoral cannulation for extracorporeal membrane oxygenation"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8581-3726","authenticated-orcid":false,"given":"Nikhil R","family":"Shah","sequence":"first","affiliation":[{"name":"Section of Pediatric Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brianna L","family":"Spencer","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn M","family":"Maselli","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyonna M","family":"Williams","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vikram","family":"Sood","sequence":"additional","affiliation":[{"name":"Congenital Heart Center, Section of Pediatric Cardiovascular Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir K","family":"Gadepalli","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arul S","family":"Thirumoorthi","sequence":"additional","affiliation":[{"name":"Section of Pediatric Surgery, C.S. Mott Children\u2019s Hospital, University of Michigan, Michigan Medicine, Ann Arbor, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,11,17]]},"reference":[{"key":"bibr1-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1097\/00002480-199911000-00018"},{"key":"bibr2-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.05.071"},{"key":"bibr3-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1111\/aor.14344"},{"key":"bibr4-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2021.01.044"},{"key":"bibr5-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2010.07.005"},{"key":"bibr6-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12861"},{"key":"bibr7-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000884"},{"key":"bibr8-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2017.11.046"},{"key":"bibr9-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2011.02.018"},{"key":"bibr10-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2013.03.011"},{"key":"bibr11-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12880"},{"key":"bibr12-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2022.11.047"},{"key":"bibr13-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001155"},{"key":"bibr14-02676591231216326","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.917875"},{"key":"bibr15-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001711"},{"key":"bibr16-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2017.06.004"},{"key":"bibr17-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000002158"},{"key":"bibr18-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-019-2541-3"},{"key":"bibr19-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.10.059"},{"key":"bibr20-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1111\/aor.12314"},{"key":"bibr21-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1532\/hsf.1824"},{"key":"bibr22-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000405"},{"key":"bibr23-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-022-04017-w"},{"key":"bibr24-02676591231216326","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-020-04800-2"},{"key":"bibr25-02676591231216326","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.03.101"}],"container-title":["Perfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591231216326","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02676591231216326","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02676591231216326","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:33:54Z","timestamp":1777656834000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02676591231216326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,17]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1177\/02676591231216326"],"URL":"https:\/\/doi.org\/10.1177\/02676591231216326","relation":{},"ISSN":["0267-6591","1477-111X"],"issn-type":[{"value":"0267-6591","type":"print"},{"value":"1477-111X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,17]]}}}