Neurologic Complications of Extracorporeal Membrane Oxygenation

Overview

Journal J Clin Neurol

Specialty Neurology

Date 2015 Sep 1

PMID 26320848

Citations 61

Authors

Deena M Nasr

Alejandro A Rabinstein

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: The rate and outcomes of neurologic complications of patients receiving extracorporeal membrane oxygenation (ECMO) are poorly understood. The purpose of this study was to identify these parameters in ECMO patients.

Methods: All patients receiving ECMO were selected from the Nationwide Inpatient Sample between 2001-2011. The rate and outcomes of neurologic complications [acute ischemic stroke, intracranial hemorrhage (ICH), and seizures] among these patients was determined. Discharge status, mortality, length of stay, and hospitalization costs were compared between patients with and without neurologic complications using chi-squared tests for categorical variables and Student's t-test for continuous variables.

Results: In total, 23,951 patients were included in this study, of which 2,604 (10.9%) suffered neurologic complications of seizure (4.1%), stroke (4.1%), or ICH (3.6%). When compared to patients without neurologic complications, acute ischemic stroke patients had significantly higher rates of discharge to a long-term facility (12.2% vs. 6.8%, p<0.0001) and a significantly longer mean length of stay (41.6 days vs. 31.9 days, p<0.0001). ICH patients had significantly higher rates of discharge to a long-term facility (9.5% vs. 6.8%, p=0.007), significantly higher mortality rates (59.7% vs. 50.0%, p<0.0001), and a significantly longer mean length of stay (41.8 days vs. 31.9 days) compared to patients without neurologic complications. These outcomes did not differ significantly between seizure patients and patients without neurologic complications.

Conclusions: Given the increasing utilization of ECMO and the high costs and poor outcomes associated with neurologic complications, more research is needed to help determine the best way to prevent these sequelae in this patient population.

Citing Articles

Extracorporeal Life Support for Cardiac Arrest and Cardiogenic Shock.

Elliott A, Dahyia G, Kalra R, Alexy T, Bartos J, Kosmopoulos M US Cardiol. 2024; 15:e23.

PMID: 39720488 PMC: 11664775. DOI: 10.15420/usc.2021.13.

Epidemiology of Seizures and Association With Mortality in Adult Patients Undergoing ECMO: A Systematic Review and Meta-analysis.

Hwang J, Akbar A, Premraj L, Ritzl E, Cho S Neurology. 2024; 103(4):e209721.

PMID: 39079068 PMC: 11760057. DOI: 10.1212/WNL.0000000000209721.

Managing medically refractory elevated intracranial pressure in a pediatric patient on ECMO: illustrative case.

Young T, Ezzat B, Nichols N, Aydin S, Pastuszko P, Morgenstern P Childs Nerv Syst. 2024; 40(11):3843-3847.

PMID: 39046474 DOI: 10.1007/s00381-024-06549-8.

Impact of extracorporeal membrane oxygenation-related complications on in-hospital mortality.

Byun E, Kang P, Jung S, Park S, Lee S, Kwon T PLoS One. 2024; 19(3):e0300713.

PMID: 38527053 PMC: 10962856. DOI: 10.1371/journal.pone.0300713.

Characterizing the Relationship Between Arterial Carbon Dioxide Trajectory and Serial Brain Biomarkers with Central Nervous System Injury During Veno-Venous Extracorporeal Membrane Oxygenation: A Prospective Cohort Study.

Thiara S, Stukas S, Hoiland R, Wellington C, Tymko M, Isac G Neurocrit Care. 2024; 41(1):20-28.

PMID: 38302643 PMC: 11335840. DOI: 10.1007/s12028-023-01923-x.

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