TY - JOUR
T1 - Brain Injury in Extracorporeal Membrane Oxygenation
T2 - A Multidisciplinary Approach
AU - Chiarini, Giovanni
AU - Cho, Sung Min
AU - Whitman, Glenn
AU - Rasulo, Frank
AU - Lorusso, Roberto
N1 - Publisher Copyright:
© 2021 American Institute of Physics Inc.. All rights reserved.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Extracorporeal membrane oxygenation (ECMO) represents an established technique to provide temporary cardiac and/or pulmonary support. ECMO, in veno-venous, veno-Arterial or in extracorporeal carbon dioxide removal modality, is associated with a high rate of brain injuries. These complications have been reported in 7 to 15% of adults and 20% of neonates, and are associated with poor survival. Thromboembolic events, loss of cerebral autoregulation, alteration of the blood-brain barrier, and hemorrhage related to anticoagulation represent the main causes of severe brain injury during ECMO. The most frequent forms of acute neurological injuries in ECMO patients are intracranial hemorrhage (2-21%), ischemic stroke (2-10%), seizures (2-6%), and hypoxic-ischemic brain injury; brain death may also occur in this population. Other frequent complications are infarction (1-8%) and cerebral edema (2-10%), as well as neuropsychological and psychiatric sequelae, including posttraumatic stress disorder.
AB - Extracorporeal membrane oxygenation (ECMO) represents an established technique to provide temporary cardiac and/or pulmonary support. ECMO, in veno-venous, veno-Arterial or in extracorporeal carbon dioxide removal modality, is associated with a high rate of brain injuries. These complications have been reported in 7 to 15% of adults and 20% of neonates, and are associated with poor survival. Thromboembolic events, loss of cerebral autoregulation, alteration of the blood-brain barrier, and hemorrhage related to anticoagulation represent the main causes of severe brain injury during ECMO. The most frequent forms of acute neurological injuries in ECMO patients are intracranial hemorrhage (2-21%), ischemic stroke (2-10%), seizures (2-6%), and hypoxic-ischemic brain injury; brain death may also occur in this population. Other frequent complications are infarction (1-8%) and cerebral edema (2-10%), as well as neuropsychological and psychiatric sequelae, including posttraumatic stress disorder.
KW - ECMO
KW - brain damage
KW - extracorporeal life support
KW - neurologic prognostication
KW - neuromonitoring
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U2 - 10.1055/s-0041-1726284
DO - 10.1055/s-0041-1726284
M3 - Article
C2 - 33851392
AN - SCOPUS:85104335211
SN - 0271-8235
VL - 41
SP - 422
EP - 436
JO - Seminars in neurology
JF - Seminars in neurology
IS - 4
ER -