Management of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation (ECMO): An observational cohort study

Intracranial hemorrhage (ICH) is a common complication in adults treated with extracorporeal membrane oxygenation (ECMO). The aim of this study was to identify predictors of outcome and investigate intervention strategies following ICH development in ECMO-treated adult patients. We conducted a retro...

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Bibliographic Details
Published in:PloS one 2017-12, Vol.12 (12), p.e0190365-e0190365
Main Authors: Fletcher-Sandersjöö, Alexander, Thelin, Eric Peter, Bartek, Jr, Jiri, Elmi-Terander, Adrian, Broman, Mikael, Bellander, Bo-Michael
Format: Article
Language:English
Subjects:
Adult
Adults
Anesthesia
Anticoagulants
Biology and Life Sciences
Brain hemorrhage
Care and treatment
Cohort analysis
Cohort Studies
Consciousness
Extracorporeal membrane oxygenation
Extracorporeal Membrane Oxygenation - adverse effects
Female
Health aspects
Hematoma
Hemorrhage
Hospitals
Humans
Hydrocephalus
Intensive care
Intracranial Hemorrhages - etiology
Intracranial Hemorrhages - mortality
Intracranial Hemorrhages - therapy
Lesions
Low level
Male
Medicin och hälsovetenskap
Medicine and Health Sciences
Middle Aged
Mortality
Neurosciences
Neurosurgery
Observational studies
Ostomy
Oxygenation
Patients
Pediatrics
Research and Analysis Methods
Respiratory therapy
Retrospective Studies
Risk factors
Statistical analysis
Stroke
Studies
Subarachnoid hemorrhage
Surgery
Traumatic brain injury
Treatment Outcome
Young Adult
Young adults
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Summary:Intracranial hemorrhage (ICH) is a common complication in adults treated with extracorporeal membrane oxygenation (ECMO). The aim of this study was to identify predictors of outcome and investigate intervention strategies following ICH development in ECMO-treated adult patients. We conducted a retrospective review of adult patients (≥18 years) who developed an ICH during ECMO treatment at the Karolinska University Hospital (Stockholm, Sweden) between September 2005 and May 2017. Outcome was assessed by 30-day mortality and Glasgow Outcome Scale (GOS) after 6 months. The statistical analysis was supplemented by a case series of patients who were surgically treated for an ICH. Sixty-five patients developed an ICH during ECMO treatment. 30-day mortality was 74% (n = 48), and was significantly associated with low level of consciousness at ICH diagnosis (p = 0.036), presence of intraparenchymal hematoma (IPH) (p = 0.049), IPH volume (p = 0.002), presence of intraventricular hemorrhage (p = 0.001), subarachnoid hemorrhage Fisher grade (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0190365