Extracorporeal membrane oxygenation (ECMO) is a technology that can temporarily take over the functions of the heart and lungs. Acute kidney injury is a common issue in patients receiving ECMO treatment, with reported incidence rates ranging from 70% to 85%.[1] To maintain the balance of fluids and electrolytes in patients, continuous renal replacement therapy (CRRT) is frequently employed.

Following the onset of peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO), acute limb ischemia has become a worrisome complication with significant implications for patient prognosis and survival.[2] It can lead to insufficient blood flow to the affected limb, potentially culminating in limb amputation or death in severe cases.[3] According to the current literature, the incidence rate of limb ischemia is approximately 17%.[4] Acute limb ischemia is typically linked to various factors, including patient comorbidities, hemodynamic factors resulting in low flow rates, and the size of catheters inserted.[5] Early detection, prevention, and management of this severe complication are imperative for emergency medicine and intensive care specialists. The attainment of successful distal limb perfusion is paramount for preventing acute limb ischemia among patients undergoing VA-ECMO.