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Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study
Non-hemorrhagic brain infarction (BI) is a recognized complication in adults treated with extracorporeal membrane oxygenation (ECMO) and associated with increased mortality. However, predictors of BI in these patients are poorly understood. The aim of this study was to identify predictors of BI in E...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884423/ https://www.ncbi.nlm.nih.gov/pubmed/33589664 http://dx.doi.org/10.1038/s41598-021-83157-5 |
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author | Iacobelli, Riccardo Fletcher-Sandersjöö, Alexander Lindblad, Caroline Keselman, Boris Thelin, Eric Peter Broman, Lars Mikael |
author_facet | Iacobelli, Riccardo Fletcher-Sandersjöö, Alexander Lindblad, Caroline Keselman, Boris Thelin, Eric Peter Broman, Lars Mikael |
author_sort | Iacobelli, Riccardo |
collection | PubMed |
description | Non-hemorrhagic brain infarction (BI) is a recognized complication in adults treated with extracorporeal membrane oxygenation (ECMO) and associated with increased mortality. However, predictors of BI in these patients are poorly understood. The aim of this study was to identify predictors of BI in ECMO-treated adult patients. We conducted an observational cohort study of all adult patients treated with venovenous or venoarterial (VA) ECMO at our center between 2010 and 2018. The primary endpoint was a computed tomography (CT) verified BI. Logistic regression models were employed to identify BI predictors. In total, 275 patients were included, of whom 41 (15%) developed a BI. Pre-ECMO Simplified Acute Physiology Score III, pre-ECMO cardiac arrest, VA ECMO and conversion between ECMO modes were identified as predictors of BI. In the multivariable analysis, VA ECMO demonstrated independent risk association. VA ECMO also remained the independent BI predictor in a sub-group analysis excluding patients who did not undergo a head CT scan during ECMO treatment. The incidence of BI in adult ECMO patients may be higher than previously believed and is independently associated with VA ECMO mode. Larger prospective trials are warranted to validate these findings and ascertain their clinical significance. |
format | Online Article Text |
id | pubmed-7884423 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-78844232021-02-16 Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study Iacobelli, Riccardo Fletcher-Sandersjöö, Alexander Lindblad, Caroline Keselman, Boris Thelin, Eric Peter Broman, Lars Mikael Sci Rep Article Non-hemorrhagic brain infarction (BI) is a recognized complication in adults treated with extracorporeal membrane oxygenation (ECMO) and associated with increased mortality. However, predictors of BI in these patients are poorly understood. The aim of this study was to identify predictors of BI in ECMO-treated adult patients. We conducted an observational cohort study of all adult patients treated with venovenous or venoarterial (VA) ECMO at our center between 2010 and 2018. The primary endpoint was a computed tomography (CT) verified BI. Logistic regression models were employed to identify BI predictors. In total, 275 patients were included, of whom 41 (15%) developed a BI. Pre-ECMO Simplified Acute Physiology Score III, pre-ECMO cardiac arrest, VA ECMO and conversion between ECMO modes were identified as predictors of BI. In the multivariable analysis, VA ECMO demonstrated independent risk association. VA ECMO also remained the independent BI predictor in a sub-group analysis excluding patients who did not undergo a head CT scan during ECMO treatment. The incidence of BI in adult ECMO patients may be higher than previously believed and is independently associated with VA ECMO mode. Larger prospective trials are warranted to validate these findings and ascertain their clinical significance. Nature Publishing Group UK 2021-02-15 /pmc/articles/PMC7884423/ /pubmed/33589664 http://dx.doi.org/10.1038/s41598-021-83157-5 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Iacobelli, Riccardo Fletcher-Sandersjöö, Alexander Lindblad, Caroline Keselman, Boris Thelin, Eric Peter Broman, Lars Mikael Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
title | Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
title_full | Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
title_fullStr | Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
title_full_unstemmed | Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
title_short | Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
title_sort | predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7884423/ https://www.ncbi.nlm.nih.gov/pubmed/33589664 http://dx.doi.org/10.1038/s41598-021-83157-5 |
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