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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

2025-08Research article Embargoed access
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dc.contributor.authorCoelho, Raquel
dc.contributor.authorTavares, Joana
dc.contributor.authorMarinheiro, Catarina
dc.contributor.authorCosta, Carina
dc.contributor.authorFerreira, Simão
dc.contributor.authorGregório, Tiago
dc.contributor.authorFerreira, Simão
dc.date.accessioned2025-09-23T10:09:21Z
dc.date.available2025-09-23T10:09:21Z
dc.date.issued2025-08
dc.description.abstractAcute 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. Evaluate the effectiveness of NIRS technology in the early diagnosis of lower limb ischemia in patients undergoing peripheral VA ECMO. 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. 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]). NIRS technology is an effective diagnostic tool for reliably detecting true positive cases of limb ischemia.por
dc.identifier.citationCoelho, R., Tavares, J., Marinheiro, C., Costa, C., Ferreira, S., & Gregório, T. (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, 104039. https://doi.org/10.1016/j.iccn.2025.104039
dc.identifier.doi10.1016/j.iccn.2025.104039
dc.identifier.eissn1532-4036
dc.identifier.issn0964-3397
dc.identifier.urihttp://hdl.handle.net/10400.22/30504
dc.language.isoeng
dc.peerreviewedyes
dc.publisherElsevier
dc.relation2023.02141.BD
dc.relation.hasversionhttps://www.sciencedirect.com/science/article/pii/S0964339725001004?via%3Dihub
dc.rights.uriN/A
dc.subjectLimb ischemia
dc.subjectLower extremities
dc.subjectSpectroscopy
dc.subjectNear-Infrared
dc.subjectVenoarterial extracorporeal membrane oxygenation
dc.subjectVenoarterial ECMO
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-analysispor
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.titleIntensive and Critical Care Nursing
oaire.citation.volume89
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameFerreira
person.givenNameSimão
person.identifier2680796
person.identifier.ciencia-idB11E-1BD3-5F34
person.identifier.orcid0000-0001-8233-2217
person.identifier.scopus-author-id57359736400
relation.isAuthorOfPublication0bd5b0fc-6849-4f36-b751-87e7f4c81eff
relation.isAuthorOfPublication.latestForDiscovery0bd5b0fc-6849-4f36-b751-87e7f4c81eff

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