Logo do repositório
 
Publicação

The effectiveness of NIRS technology to the early diagnosis of lower limb ischemia in patients on peripheral VA ECMO: a systematic review and meta-analysis

2025-08-01Artigo de revisão Acesso aberto
Ver registo simples
dc.contributor.authorCoelho, Raquel
dc.contributor.authorTavares, Joana
dc.contributor.authorMarinheiro, Catarina
dc.contributor.authorCosta, Carina
dc.contributor.authorGregório, Tiago
dc.contributor.authorFerreira, Simão
dc.date.accessioned2026-03-11T07:49:52Z
dc.date.available2026-03-11T07:49:52Z
dc.date.issued2025-08-01
dc.description.abstractBackground: Acute lower limb ischemia is a major complication of peripheral venoarterial ECMO, significantly impacting patient outcomes and survival rates. Traditional methods for assessing limb perfusion, such as physical exams and Doppler ultrasound, are often unreliable and do not provide continuous monitoring. Near-infrared spectroscopy (NIRS), a non-invasive technique, shows promise for perfusion monitoring in venoarterial ECMO patients, but its effectiveness in the early detection of limb hypoperfusion remains unreviewed. Aim: Evaluate the effectiveness of NIRS technology in the early diagnosis of lower limb ischemia in patients undergoing peripheral VA ECMO. Methods: The search strategy covered five databases. Inclusion criteria included studies in Portuguese, English, Spanish, or German involving participants aged 18 or older dependent on peripheral VA ECMO. The intervention assessed was limb perfusion monitoring using NIRS in VA ECMO patients. The primary outcome was the effectiveness of NIRS in the early diagnosis of limb ischemia. Exclusion criteria included review articles, book chapters, books, editorials, conference papers, and studies on pediatric patients, central VA ECMO, or venovenous ECMO. Study quality was evaluated using the ROBINS-I tool. Meta-analysis was performed using R package meta. Narrative synthesis was applied when meta-analysis was unfeasible. Results: Of 180 studies, 164 were excluded after initial screening. Of the remaining 16 studies, eight were removed for irrelevance, high bias risk, or pediatric focus, leaving eight studies. The results revealed a pooled sensitivity of the diagnostic method of 0.71 (95% CI: [0.67, 0.74]) and a pooled specificity of 0.68 (95% CI: [0.61, 0.74]). Conclusions: NIRS technology is an effective diagnostic tool for reliably detecting true positive cases of limb ischemia. Implications for Clinical Practice: The decrease in NIRS values and the difference between limbs may indicate hypoperfusion, requiring further investigation. NIRS also helps assess distal perfusion catheter functionality, enhancing our ability to provide safe, high-quality care.eng
dc.identifier.citationCoelho, R., Tavares, J., Marinheiro, C., & Costa, C. et al. (2025). The effectiveness of NIRS technology to the early diagnosis of lower limb ischemia in patients on peripheral VA ECMO: a systematic review and meta-analysis. Intensive and Critical Care Nursing, 89, Article 104039. https://doi.org/10.1016/j.iccn.2025.104039
dc.identifier.doi10.1016/j.iccn.2025.104039
dc.identifier.eid105002473110
dc.identifier.issn0964-3397
dc.identifier.other23ff7c2e-facc-4adc-a41c-a08c6468cfe9
dc.identifier.pmid40233544
dc.identifier.urihttp://hdl.handle.net/10400.14/57305
dc.identifier.wos001471958000001
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectLimb ischemia
dc.subjectLower extremities
dc.subjectSpectroscopy, near-infrared
dc.subjectVenoarterial ECMO
dc.subjectVenoarterial extracorporeal membrane oxygenation
dc.titleThe effectiveness of NIRS technology to the early diagnosis of lower limb ischemia in patients on peripheral VA ECMO: a systematic review and meta-analysiseng
dc.typereview article
dspace.entity.typePublication
oaire.citation.titleIntensive and Critical Care Nursing
oaire.citation.volume89
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

Ficheiros

Principais
A mostrar 1 - 1 de 1
Miniatura
Nome:
117975313.pdf
Tamanho:
1.96 MB
Formato:
Adobe Portable Document Format
Ver/Abrir

Coleções

CIIS - Contribuições em Revistas Científicas / Contribution to Journals