"【Abstract】Background Limb ischemia is a common complication during peripheral venous-arterial extracorporeal membrane pulmonary oxygenation (VA-ECMO) in adults, to which the prognosis of patients is closely related, however, there currently is still a lack of evidence-based practice guidance aiming at limb ischemia. Objective To retrieve, evaluate, and summarize the best evidence for the prevention and treatment of limb ischemia in adult peripheral venous-arterial extracorporeal membrane pulmonary oxygenation (VA-ECMO) patients to provide reference for clinical practice. Methods A computerized search of up to 16 domestic and international Chinese and English databases such as Extracorporeal Life Support Organization, Cochrane Library, and PubMed for relevant literature on the prevention and treatment of limb ischemia in adults with VA-ECMO, including clinical practice guidelines, evidence summaries, clinical decision making, expert consensus, systematic evaluation, and the search period was from the establishment of the database to August 2023. Literature screening and quality assessment were performed independently by 2 researchers, and evidence was extracted, summarized, and aggregated according to topics. Results A total of 12 publications were included, including 3 guidelines, 4 systematic evaluations, and 5 expert consensus. Thirty-four pieces of evidence were summarized in five areas: preplacement assessment, choice of placement, monitoring and management during operation, post-withdrawal management, and team building. Conclusion Clinical healthcare professionals should seek rational evidence according to the realistic situation of patients and actively adopt effective interventions to reduce the occurrence of limb ischemia.
【Keywords】 extracorporeal membrane pulmonary oxygenation; V-A ECMO; limb ischemia; evidence-based nursing care"