Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has become an essential life-saving therapy for patients with refractory cardiogenic shock, cardiac arrest, and severe cardiopulmonary failure. Despite its expanding use and technological advancements, V-A ECMO is associated with significant complications, among which limb ischaemia remains one of the most devastating. The systematic review and meta-analysis by Guo et al., published in Nursing in Critical Care in 2026, provides one of the most comprehensive evaluations to date of the incidence and risk factors of limb ischaemia in adult patients supported with V-A ECMO.

The authors conducted a rigorous literature search across five major databases—PubMed, Web of Science, Embase, Cochrane Library, and Scopus—from inception through June 2025. Following PRISMA guidelines and PROSPERO registration, 17 observational studies encompassing 2,812 adult patients were included. Most studies were cohort designs, geographically diverse, and predominantly focused on peripherally cannulated V-A ECMO, reflecting contemporary clinical practice. Methodological quality was generally high, with Newcastle–Ottawa Scale scores ranging from 6 to 9.