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[Clinical application effect of the improved three-level fixation method in percutaneous extracorporeal membrane
Peijun Ren1, Bowen Zhang, Xiaoliang Qian
1Department of Cardiopulmonary Bypass and Extracorporeal Life Support, Fuwai Central China Cardiovascular Hospital, Zhengzhou 450000, China. Corresponding author: Li Jianchao,
Objective:
To explore the clinical application effect of the improved three-level fixation method in percutaneous extracorporeal membrane oxygenation (ECMO) catheter fixation.
Methods:
A retrospective cohort research method was conducted. Clinical data of patients who underwent percutaneous ECMO catheterization treatment and were admitted to the Extracorporeal Life Support Center of Fuwai Huazhong Cardiovascular Hospital from June 2021 to June 2025 were collected. Patients were divided into a traditional fixation method group and a modified fixation method group based on different ways of catheter fixation. The incidence of catheter dislodgement, bleeding at the catheterization site, and skin injury-related infections in patients receiving different ECMO catheter fixation methods was statistically analyzed. A questionnaire survey was conducted to assess the comfort level of conscious patients undergoing different ECMO catheter fixation methods and the satisfaction of nurses in caring for patients with different ECMO catheter fixation methods.
Results:
A total of 586 patients undergoing percutaneous ECMO catheterization were enrolled, including 214 in the traditional fixation group and 372 in the modified fixation group. There were no statistically significant differences in gender, age, disease type, proportion of awake ECMO patients, proportion of ECMO operations performed outside the hospital, and duration of ECMO operation between the two groups. The modified fixation group had lower rates of catheter dislodgement, bleeding at the catheterization site, and skin injury-related infections compared to the traditional fixation group [catheter dislodgement: 0% (0/372) vs. 1.4% (3/214), bleeding at the catheterization site: 5.3% (20/372) vs. 15.8% (34/214), skin injury-related infections: 4.0% (15/372) vs. 22.4% (48/214), all P<0.05]. The comfort level of awake patients and the satisfaction of nursing staff in the modified fixation group were higher than those in the traditional fixation group [comfort level of awake patients: 68.7% (22/32) vs. 23.5% (4/17), satisfaction of nursing staff: 89.2% (332/372) vs. 63.5% (136/214), both P<0.05].
Conclusions:
The improved "three-level" fixation method can significantly reduce the incidence of catheter dislodgement, bleeding at the catheterization site, and skin injury-related infections in percutaneous puncture ECMO catheter fixation, and can be used as one of the effective measures for continuous improvement of ECMO quality control. It can also significantly improve the comfort level of conscious patients and the satisfaction of nursing staff in clinical work, and is recommended for clinical promotion and application.
