Neurologic Injury in Patients Treated With Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock

التفاصيل البيبلوغرافية
العنوان: Neurologic Injury in Patients Treated With Extracorporeal Membrane Oxygenation for Postcardiotomy Cardiogenic Shock
المؤلفون: Toivonen, Fanni, Biancari, Fausto, Dalén, Magnus, Dell'Aquila, Angelo M., Jónsson, Kristján, Fiore, Antonio, Mariscalco, Giovanni, El-Dean, Zein, Gatti, Giuseppe, Zipfel, Svante, Perrotti, Andrea, Bounader, Karl, Alkhamees, Khalid, Loforte, Antonio, Lechiancole, Andrea, Pol, Marek, Spadaccio, Cristiano, Pettinari, Matteo, De Keyzer, Dieter, Welp, Henryk, Lichtenberg, Artur, Saeed, Diyar, Ruggieri, Vito G., Ragnarsson, Sigurdur
المصدر: Journal of Cardiothoracic and Vascular Anesthesia. 35(9):2669-2680
مصطلحات موضوعية: extracorporeal membrane oxygenation, intracerebral hemorrhage, ischemic stroke, neurologic injury, outcome, postcardiotomy shock, stroke, Medicin och hälsovetenskap, Klinisk medicin, Kardiologi, Medical and Health Sciences, Clinical Medicine, Cardiac and Cardiovascular Systems
الوصف: Objective: To investigate the frequency, predictors, and outcomes of neurologic injury in adults treated with postcardiotomy extracorporeal membrane oxygenation (PC-ECMO). Design: A retrospective multicenter registry study. Setting: Twenty-one European institutions where cardiac surgery is performed. Participants: A total of 781 adult patients who required PC-ECMO during 2010 to 2018 were divided into patients with neurologic injury (NI) and patients without neurologic injury (NNI). Measurements and Main Results: Baseline and operative data, in-hospital outcomes, and long-term survival were compared between the NI and the NNI groups. Predictors of neurologic injury were identified. A subgroup analysis according to the type of neurologic injury was performed. Overall, NI occurred in 19% of patients in the overall series, but the proportion of patients with NI ranged from 0% to 65% among the centers. Ischemic stroke occurred in 84 patients and hemorrhagic stroke in 47 patients. Emergency procedure was the sole independent predictor of NI. In-hospital mortality was higher in the NI group than in the NNI group (79% v 61%, p < 0.001). The one-year survival was lower in the NI group (17%) compared with the NNI group (37%). Long-term survival did not differ between patients with ischemic stroke and those with hemorrhagic stroke. Conclusion: Neurologic injury during PC-ECMO is common and associated with a dismal prognosis. There is considerable interinstitutional variation in the proportion of neurologic injury in PC-ECMO-treated adults. Well-known risk factors for stroke are not associated with neurologic injury in this setting.
URL الوصول: https://lup.lub.lu.se/record/3900e139-5b18-4965-8a7c-2bf4efa2f4ed
http://dx.doi.org/10.1053/j.jvca.2020.11.004
قاعدة البيانات: SwePub
الوصف
تدمد:10530770
DOI:10.1053/j.jvca.2020.11.004