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Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study

Extracorporeal membrane oxygenation (ECMO) is potentially lifesaving for patients with acute respiratory distress syndrome (ARDS) but may be accompanied by serious adverse events, including intracranial hemorrhage (ICRH). We hypothesized that ICRH occurs more frequently in patients with COVID-19 tha...

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Autores principales: Pantel, Tobias, Roedl, Kevin, Jarczak, Dominik, Yu, Yuanyuan, Frings, Daniel Peter, Sensen, Barbara, Pinnschmidt, Hans, Bernhardt, Alexander, Cheng, Bastian, Lettow, Iris, Westphal, Manfred, Czorlich, Patrick, Kluge, Stefan, Fischer, Marlene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745037/
https://www.ncbi.nlm.nih.gov/pubmed/35011769
http://dx.doi.org/10.3390/jcm11010028
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author Pantel, Tobias
Roedl, Kevin
Jarczak, Dominik
Yu, Yuanyuan
Frings, Daniel Peter
Sensen, Barbara
Pinnschmidt, Hans
Bernhardt, Alexander
Cheng, Bastian
Lettow, Iris
Westphal, Manfred
Czorlich, Patrick
Kluge, Stefan
Fischer, Marlene
author_facet Pantel, Tobias
Roedl, Kevin
Jarczak, Dominik
Yu, Yuanyuan
Frings, Daniel Peter
Sensen, Barbara
Pinnschmidt, Hans
Bernhardt, Alexander
Cheng, Bastian
Lettow, Iris
Westphal, Manfred
Czorlich, Patrick
Kluge, Stefan
Fischer, Marlene
author_sort Pantel, Tobias
collection PubMed
description Extracorporeal membrane oxygenation (ECMO) is potentially lifesaving for patients with acute respiratory distress syndrome (ARDS) but may be accompanied by serious adverse events, including intracranial hemorrhage (ICRH). We hypothesized that ICRH occurs more frequently in patients with COVID-19 than in patients with ARDS of other etiologies. We performed a single-center retrospective analysis of adult patients treated with venovenous (vv-) ECMO for ARDS between January 2011 and April 2021. Patients were included if they had received a cranial computed tomography (cCT) scan during vv-ECMO support or within 72 h after ECMO removal. Cox regression analysis was used to identify factors associated with ICRH. During the study period, we identified 204 patients with vv-ECMO for ARDS, for whom a cCT scan was available. We observed ICRH in 35.4% (n = 17/48) of patients with COVID-19 and in 16.7% (n = 26/156) of patients with ARDS attributable to factors other than COVID-19. COVID-19 (HR: 2.945; 95%; CI: 1.079–8.038; p = 0.035) and carboxyhemoglobin (HR: 0.330; 95%; CI: 0.135–0.806; p = 0.015) were associated with ICRH during vv-ECMO. In patients receiving vv-ECMO, the incidence of ICRH is doubled in patients with COVID-19 compared to patients suffering from ARDS attributable to other causes. More studies on the association between COVID-19 and ICRH during vv-ECMO are urgently needed to identify risk patterns and targets for potential therapeutic interventions.
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spelling pubmed-87450372022-01-11 Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study Pantel, Tobias Roedl, Kevin Jarczak, Dominik Yu, Yuanyuan Frings, Daniel Peter Sensen, Barbara Pinnschmidt, Hans Bernhardt, Alexander Cheng, Bastian Lettow, Iris Westphal, Manfred Czorlich, Patrick Kluge, Stefan Fischer, Marlene J Clin Med Article Extracorporeal membrane oxygenation (ECMO) is potentially lifesaving for patients with acute respiratory distress syndrome (ARDS) but may be accompanied by serious adverse events, including intracranial hemorrhage (ICRH). We hypothesized that ICRH occurs more frequently in patients with COVID-19 than in patients with ARDS of other etiologies. We performed a single-center retrospective analysis of adult patients treated with venovenous (vv-) ECMO for ARDS between January 2011 and April 2021. Patients were included if they had received a cranial computed tomography (cCT) scan during vv-ECMO support or within 72 h after ECMO removal. Cox regression analysis was used to identify factors associated with ICRH. During the study period, we identified 204 patients with vv-ECMO for ARDS, for whom a cCT scan was available. We observed ICRH in 35.4% (n = 17/48) of patients with COVID-19 and in 16.7% (n = 26/156) of patients with ARDS attributable to factors other than COVID-19. COVID-19 (HR: 2.945; 95%; CI: 1.079–8.038; p = 0.035) and carboxyhemoglobin (HR: 0.330; 95%; CI: 0.135–0.806; p = 0.015) were associated with ICRH during vv-ECMO. In patients receiving vv-ECMO, the incidence of ICRH is doubled in patients with COVID-19 compared to patients suffering from ARDS attributable to other causes. More studies on the association between COVID-19 and ICRH during vv-ECMO are urgently needed to identify risk patterns and targets for potential therapeutic interventions. MDPI 2021-12-22 /pmc/articles/PMC8745037/ /pubmed/35011769 http://dx.doi.org/10.3390/jcm11010028 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pantel, Tobias
Roedl, Kevin
Jarczak, Dominik
Yu, Yuanyuan
Frings, Daniel Peter
Sensen, Barbara
Pinnschmidt, Hans
Bernhardt, Alexander
Cheng, Bastian
Lettow, Iris
Westphal, Manfred
Czorlich, Patrick
Kluge, Stefan
Fischer, Marlene
Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study
title Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study
title_full Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study
title_fullStr Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study
title_full_unstemmed Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study
title_short Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study
title_sort association of covid-19 with intracranial hemorrhage during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a 10-year retrospective observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8745037/
https://www.ncbi.nlm.nih.gov/pubmed/35011769
http://dx.doi.org/10.3390/jcm11010028
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