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. 2015 Oct;11(4):383-9.
doi: 10.3988/jcn.2015.11.4.383. Epub 2015 Aug 21.

Neurologic Complications of Extracorporeal Membrane Oxygenation

Deena M Nasr  1 , Alejandro A Rabinstein  2
Affiliations

Neurologic Complications of Extracorporeal Membrane Oxygenation

Deena M Nasr et al. J Clin Neurol. 2015 Oct.

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.

Keywords: extracorporeal membrane oxygenation; neurology/neurologic (deficits, disease, injury); stroke.

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Conflict of interest statement

Conflicts of Interest: The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Number of patients treated with extracorporeal membrane oxygenation (ECMO) during the period 2001-2011. Graphical representation of ECMO utilization in the United States Nationwide Inpatient Sample from the period 2001-2011. ECMO utilization increased from 1,613 patients in 2001 to 3,597 patients in 2011. Utilization in adults increased from 309 patients in 2001 to 2004 patients in 2011; these data for the pediatric population are 1,027 and 1,434 patients, respectively.
See this image and copyright information in PMC

References

    1. Marasco SF, Lukas G, McDonald M, McMillan J, Ihle B. Review of ECMO (extra corporeal membrane oxygenation) support in critically ill adult patients. Heart Lung Circ. 2008;17(Suppl 4):S41–S47. - PubMed
    1. Bulas DI, Taylor GA, O'Donnell RM, Short BL, Fitz CR, Vezina G. Intracranial abnormalities in infants treated with extracorporeal membrane oxygenation: update on sonographic and CT findings. AJNR Am J Neuroradiol. 1996;17:287–294. - PMC - PubMed
    1. Australia and New Zealand Extracorporeal Membrane Oxygenation (ANZ ECMO) Influenza Investigators. Davies A, Jones D, Bailey M, Beca J, Bellomo R, et al. Extracorporeal Membrane Oxygenation for 2009 Influenza A(H1N1) Acute Respiratory Distress Syndrome. JAMA. 2009;302:1888–1895. - PubMed
    1. Mateen FJ, Muralidharan R, Shinohara RT, Parisi JE, Schears GJ, Wijdicks EF. Neurological injury in adults treated with extracorporeal membrane oxygenation. Arch Neurol. 2011;68:1543–1549. - PMC - PubMed
    1. Graziani LJ, Gringlas M, Baumgart S. Cerebrovascular complications and neurodevelopmental sequelae of neonatal ECMO. Clin Perinatol. 1997;24:655–675. - PubMed