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ECMO brain injury

Venessa L Pinto, Sumit Pruthi, Ashly C Westrick, Chevis N Shannon, Brian C Bridges, Truc M Le
Neurologic complications can occur with ECMO due to several factors. Prior studies identified neonates as having unique risk factors and neuro-imaging findings post-ECMO. The aim of this study is to describe brain MRI findings of pediatric patients treated with ECMO. We conducted a retrospective study of non-neonatal pediatric patients who underwent a comprehensive brain MRI after ECMO, between January 2000 and July 2015. We identified 47 pediatric patients in the study cohort with a median age of 8 months (IQR 3-170mo) and a median ECMO run duration of 7...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Marie-Philippine Clair, Jérôme Rambaud, Adrien Flahault, Romain Guedj, Julia Guilbert, Isabelle Guellec, Amélie Durandy, Maryne Demoulin, Sandrine Jean, Delphine Mitanchez, François Chalard, Chiara Sileo, Ricardo Carbajal, Sylvain Renolleau, Pierre-Louis Léger
OBJECTIVES: Extracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2) on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions...
2017: PloS One
Pilar Anton-Martin, Bruno Braga, Stephen Megison, Janna Journeycake, Jessica Moreland
Severe trauma may cause refractory life-threatening respiratory failure requiring extracorporeal membrane oxygenation (ECMO). Concurrent traumatic brain injury, however, complicates the use of ECMO because of the major risk of intracranial bleeding with systemic anticoagulation. Craniotomy and/or craniectomy for hematoma evacuation during ECMO are extremely high-risk procedures secondary to ongoing anticoagulation, and there are only a few such case reports in the literature.We present the case of a child with multiple thoracic injuries and life-threatening respiratory failure supported on ECMO...
October 4, 2016: Pediatric Emergency Care
Xiaoli Fan, Zhiquan Chen, David Nasralla, Xianpeng Zeng, Jing Yang, Shaojun Ye, Yi Zhang, Guizhu Peng, Yanfeng Wang, Qifa Ye
Between 2010 and 2013, we recorded 66 cases of failed organ donation after brain death (DBD) due to the excessive use of the vasoactive drugs resulting in impaired hepatic and/or renal function. To investigate the effect of extracorporeal membrane oxygenation (ECMO) in donor management, ECMO was used to provide support for DBD donors with circulatory and/or respiratory failure from 2013 to 2015. A retrospective cohort study between circulatory non-stable DBD with vasoactive drugs (DBD-drug) and circulatory non-stable DBD with ECMO (DBD-ECMO) was designed to compare the transplant outcomes...
October 2016: Clinical Transplantation
Sherreen G Batts, Thornton S Mu, Jane H Uyehara-Lock, Lee-Ann Murata, Catherine F T Uyehara
Cerebrovascular injury while on extracorporeal membrane oxygenation (ECMO) may be caused by excessive brain perfusion during hypoxemic reperfusion. Previous studies have postulated that the most vulnerable period of time for cerebrovascular injury is during the transfer period to ECMO. Therefore, our objective was to compare brain perfusion and hemodynamics in a piglet endotoxic shock ECMO model. The effect of ECMO flow on microcirculation of different brain regions was compared between 10 control pigs and six pigs (7-10 kg) administered IV endotoxin to achieve a drop in mean arterial blood pressure (MAP) of at least 30%...
November 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Atsushi Sato, Kikuo Isoda, Yodo Gatate, Koji Akita, Hiroyuki Daida
A 69-year-old man was admitted to our hospital with cardiopulmonary arrest. Percutaneous cardio-pulmonary support (PCPS) using the right femoral artery and vein was initiated, because ventricular fibrillation continued. Although we succeeded in defibrillation after percutaneous coronary intervention (PCI), a chest radiograph indicated a pneumothorax in the right lung and a pulmonic contusion in the left lung caused by cardiopulmonary resuscitation. Two days after PCI, partial pressure of arterial oxygen (PaO2) from the right radial artery suddenly decreased, and his cardiac function showed improvement on an echocardiogram...
2016: Internal Medicine
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Patrick L Bosarge, Lauren Allen Raff, Gerald McGwin, Shannon L Carroll, Scott C Bellot, Enrique Diaz-Guzman, Jeffrey D Kerby
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in the trauma population has been reported to have a mortality benefit in patients with severe refractory hypoxic respiratory failure. This study compares the early initiation of ECMO for the management of severe adult respiratory distress syndrome (ARDS) versus a historical control immediately preceding the use of ECMO for trauma patients. METHODS: A retrospective study was conducted at a single verified Level I trauma center...
August 2016: Journal of Trauma and Acute Care Surgery
Charles-Edouard Luyt, Nicolas Bréchot, Pierre Demondion, Tamara Jovanovic, Guillaume Hékimian, Guillaume Lebreton, Ania Nieszkowska, Matthieu Schmidt, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes
PURPOSE: The frequency of neurological events and their impact on patients receiving venovenous extracorporeal membrane oxygenation (VV-ECMO) are unknown. We therefore study the epidemiology, risk factors, and impact of cerebral complications occurring in VV-ECMO patients. METHODS: Observational study conducted in a tertiary referral center (2006-2012) on patients developing a neurological complication (ischemic stroke or intracranial bleeding) while on VV-ECMO versus those who did not, and a systematic review on this topic...
May 2016: Intensive Care Medicine
Gennaro Martucci, Vincenzina Lo Re, Antonio Arcadipane
Extracorporeal membrane oxygenation (ECMO) is a life-saving mechanical respiratory and/or circulatory support for potentially reversible severe heart or respiratory injury untreatable with conventional therapies. Thanks to the technical and management improvements the use of ECMO has increased dramatically in the last few years. Data in the literature show a progressive increase in the overall outcome. Considering the improving survival rate of patients on ECMO, and the catastrophic effect of neurological injuries in such patients, the topic of neurological damage during the ICU stay in ECMO is gaining importance...
July 2016: Neurological Sciences
Gopal Singh, Masaki Tsukashita, Mauer Biscotti, Joseph Costa, Daniel Lambert, Matthew Bacchetta, Hiroo Takayama
We report the case of a 37-year-old woman with acute respiratory distress syndrome and became a candidate for organ donation after anoxic brain injury and was on a venovenous extracorporeal membrane oxygenation (VV-ECMO) support. On preoperative evaluation and gross examination, the donor's heart was acceptable for heart transplantation to a 62-year-old female patient with a history of nonischemic cardiomyopathy with a HeartMate II mechanical assist device. Orthotopic heart transplantation was successfully performed in the recipient...
May 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Graham Peigh, Nicholas Cavarocchi, Hitoshi Hirose
OBJECTIVE: Despite advances in medical care, survival to discharge and full neurologic recovery after cardiac arrest remains less than 20% after cardiopulmonary resuscitation. An alternate approach to traditional cardiopulmonary resuscitation is extracorporeal cardiopulmonary resuscitation, which places patients on extracorporeal membrane oxygenation during cardiopulmonary resuscitation and provides immediate cardiopulmonary support when traditional resuscitation has been unsuccessful...
November 2015: Journal of Thoracic and Cardiovascular Surgery
Xian-Sheng Zhu, Sha-Sha Wang, Qi Cheng, Chuang-Wen Ye, Feng Huo, Peng Li
Extracorporeal membrane oxygenation (ECMO) has been used to support brain-dead donors for liver procurement. This study investigated the potential role of ultrasonographic monitoring of hepatic perfusion as an aid to improve the viability of liver transplants obtained from brain-dead donors who are supported on ECMO. A total of 40 brain-dead patients maintained on ECMO served as the study population. Hepatic blood flow was monitored using ultrasonography, and perioperative optimal perfusion was maintained by calibrating ECMO...
February 2016: Liver Transplantation
Melania M Bembea, Nicole Rizkalla, James Freedy, Noah Barasch, Dhananjay Vaidya, Peter J Pronovost, Allen D Everett, Gregory Mueller
OBJECTIVE: To determine if elevations in plasma brain injury biomarkers are associated with outcome at hospital discharge in children who require extracorporeal membrane oxygenation. DESIGN: Prospective observational study. SETTING: Single tertiary-care academic center. PARTICIPANTS: Eighty children who underwent extracorporeal membrane oxygenation between June 2010 and December 2013. INTERVENTIONS: None...
October 2015: Critical Care Medicine
Ren Dewei, Walid K Abu Saleh, Odeaa Al Jabbari, Basel Ramlawi, Brian A Bruckner, Eddie Suarez, Matthias Loebe
We report the case of a 50-year-old man with congestive heart failure who became a candidate for organ donation after anoxic brain injury after cardiopulmonary resuscitation (CPR) who was on a venoarterial extracorporeal membrane oxygenation (ECMO) support. On visualization, the donor's lung was acceptable for lung transplantation to a 68-year-old male patient with a chronic history of pulmonary fibrosis. Right single-lung implantation was successfully performed in the recipient. Herein, we report a case that highlights our institution's result suggesting that the use of a lung previously on ECMO support can safely and potentially expand the donor lung pool in carefully selected patients...
November 2015: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Melania M Bembea, Ryan Felling, Blair Anton, Cynthia F Salorio, Michael V Johnston
OBJECTIVE: Neurologic injury remains a significant morbidity and risk factor for mortality in critically ill patients undergoing extracorporeal membrane oxygenation. Our goal was to systematically review the literature on the use of neuromonitoring methods during extracorporeal membrane oxygenation. DATA SOURCES: Electronic searches of PubMed, CINAHL, EMBASE, Web of Science, Cochrane, and Scopus were conducted in March 2014, using a combination of medical subject heading terms and text words to define concepts of extracorporeal life support, neurologic monitoring techniques, evaluation, and outcomes...
July 2015: Pediatric Critical Care Medicine
Shih-Chi Wu, William Tzu-Liang Chen, Hui-Han Lin, Chih-Yuan Fu, Yu-Chun Wang, Hung-Chieh Lo, Han-Tsung Cheng, Chia-Wei Tzeng
OBJECTIVES: The use of extracorporeal membrane oxygenation (ECMO) in managing acute respiratory distress syndrome had been accepted. Severe lung injury with respiratory failure is often encountered in trauma patients. We report our experience with the use of ECMO in severe traumatic lung injury. METHODS: Patients with severe traumatic lung injury that met the following criteria were candidates for ECMO: (1) severe hypoxemia, Pao2/fraction of inspired oxygen (1.0) less than 60, and positive end-expiratory pressure greater than 10 cm H2O in spite of vigorous ventilation strategy; (2) irreversible CO2 retention with unstable hemodynamics; and (3) an initial arterial Pao2/fraction of inspired oxygen (1...
May 2015: American Journal of Emergency Medicine
An N Massaro
MRI performed in the neonatal period has become a tool widely used by clinicians and researchers to evaluate the developing brain. MRI can provide detailed anatomical resolution, enabling identification of brain injuries due to various perinatal insults. This review will focus on the link between neonatal MRI findings and later neurodevelopmental outcomes in high-risk term infants. In particular, the role of conventional and advanced MR imaging in prognosticating outcomes in neonates with hypoxic-ischemic encephalopathy, ischemic perinatal stroke, need for extracorporeal membrane oxygenation life support, congenital heart disease, and other neonatal neurological conditions will be discussed...
March 2015: Seminars in Perinatology
M Biscotti, W D Gannon, D Abrams, C Agerstrand, J Claassen, D Brodie, M Bacchetta
Venovenous extracorporeal membrane oxygenation (ECMO) is used for patients with severe, potentially reversible, respiratory failure unresponsive to conventional management. It is relatively contraindicated in patients with traumatic brain injury (TBI) due to bleeding complications and use of anticoagulation. We report two cases of TBI patients treated with ECMO.
July 2015: Perfusion
R Zhou, B Liu, K Lin, R Wang, Z Qin, R Liao, Y Qiu
Extracorporeal membrane oxygenation (ECMO) may offer life-saving treatment in severe pulmonary contusion or acute respiratory distress syndrome when conventional treatments have failed. However, because of the bleeding risk of systemic anticoagulation, ECMO should be performed only as a last resort in multiple trauma victims. Here, we report ECMO as a bridge for right main bronchus reconstruction and recovery of traumatic wet lung in a 31-year-old male multi-trauma patient with right main bronchial disruption, bilateral pulmonary contusion, cerebral contusion and long bone fracture...
July 2015: Perfusion
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