Lorusso, Roberto and Barili, Fabio and Di Mauro, Michele and Gelsomino, Sandro and Parise, Orlando and Rycus, Peter T. and Maessen, Jos and Mueller, Thomas and Muellenbach, Raf and Belohlavek, Jan and Peek, Giles and Combes, Alain and Frenckner, Bjorn and Pesenti, Antonio and Thiagarajan, Ravi R. (2016) I n-Hospital Neurologic Complications in Adult Patients Undergoing Venoarterial Extracorporea l Membrane Oxygenation: Results From the Extracorporeal Life Support Organization Registry. CRITICAL CARE MEDICINE, 44 (10). E964-E972. ISSN 0090-3493, 1530-0293
Full text not available from this repository. (Request a copy)Abstract
Objevtives: To elucidate the epidemiology, complication profiles, hospital outcome, and predisposing factors of CNS complications occurring during venoarterial extracorporeal membrane oxygenation in adults. Design: Retrospective analysis of the Extracorporeal Life Support Organization registry. Setting: Data reported to Extracorporeal Life Support Organization by 230 extracorporeal membrane oxygenation centers from 1992 to 2013. Patients: Patients more than 16 years old supported with a singlerun of venoarterial extracorporeal membrane oxygenation. Interventions: None. Measurements and Main Results: We examined 4,522 adult patients supported with venoarterial extracorporeal membrane oxygenation and included in the Extracorporeal Life Support Organization registry. Venoarterial extracorporeal membrane oxygenation was used for cardiac dysfunction in 3,005 patients (66.5%), cardiopulmonary resuscitation in 877 patients (19.4%), and respiratory failure in 640 patients (14.1%), respectively. Multivariate logistic regression was performed to identify factors independently associated with CNS injury. Neurologic complications occurred in 682 patients (15.1%), and included brain death in 358 patients (7.9%), cerebral infarction in 161 patients (3.6%), seizures in 83 patients (1.8%), and cerebral hemorrhage in 80 patients (1.8%). Multiple CNS complications in the same patient occurred in 70 cases. Hospital mortality in patients with CNS complications was 89%, compared with 57% in patients without (p < 0.001). In a multivariable model, age, pre-extracorporeal membrane oxygenation cardiac arrest, the use of inotropes on extracorporeal membrane oxygenation, and post-extracorporeal membrane oxygenation hypoglycemia were shown to be associated with CNS complications. Conclusions: Neurologic complications in adult patients on venoarterial extracorporeal membrane oxygenation support are common and associated with poor survival. Further research should focus on better understanding and management of brain/extracorporeal membrane oxygenation interaction to avoid such catastrophic complications.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ; cardiac-assist device; cardiopulmonary resuscitation; cerebrovascular disorders; extracorporeal circulation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 04 Apr 2019 11:33 |
| Last Modified: | 04 Apr 2019 11:33 |
| URI: | https://pred.uni-regensburg.de/id/eprint/4259 |
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