1. Lower Oxygen Tension and Intracranial Hemorrhage in Veno-venous Extracorporeal Membrane Oxygenation
- Author
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Akbar, Armaan F., Shou, Benjamin L., Feng, Cheng-Yuan, Zhao, David X., Kim, Bo Soo, Whitman, Glenn, and Bush, Errol L.
- Subjects
Brain -- Hemorrhage -- Injuries ,Blood gases -- Analysis ,Health - Abstract
Introduction and Methods We examined the relationship between 24-h pre- and post-cannulation arterial oxygen tension (PaO.sub.2) and arterial carbon dioxide tension (PaCO.sub.2) and subsequent acute brain injury (ABI) in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) with granular arterial blood gas (ABG) data and institutional standardized neuromonitoring. Results Eighty-nine patients underwent VV-ECMO (median age = 50, 63% male). Twenty (22%) patients experienced ABI; intracranial hemorrhage (ICH) was the most common diagnosis (n = 14, 16%). Lower post-cannulation PaO.sub.2 levels were significantly associated with ICH (66 vs. 81 mmHg, p = 0.007) and a post-cannulation PaO.sub.2 level < 70 mmHg was more frequent in these patients (71% vs. 33%, p = 0.007). PaCO.sub.2 parameters were not associated with ABI. By multivariable logistic regression, hypoxemia post-cannulation increased the odds of ICH (OR = 5.06, 95% CI:1.41-18.17; p = 0.01). Conclusion In summary, lower oxygen tension in the 24-h post-cannulation was associated with ICH development. The precise roles of peri-cannulation ABG changes deserve further investigation, as they may influence the management of VV-ECMO patients., Author(s): Armaan F. Akbar [sup.1], Benjamin L. Shou [sup.1], Cheng-Yuan Feng [sup.1] [sup.2] [sup.3] [sup.4], David X. Zhao [sup.1] [sup.2] [sup.3] [sup.4], Bo Soo Kim [sup.3], Glenn Whitman [sup.1], Errol [...]
- Published
- 2023
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