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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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/1/28 |
| _version_ | 1797498646709665792 |
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| author | Tobias Pantel Kevin Roedl Dominik Jarczak Yuanyuan Yu Daniel Peter Frings Barbara Sensen Hans Pinnschmidt Alexander Bernhardt Bastian Cheng Iris Lettow Manfred Westphal Patrick Czorlich Stefan Kluge Marlene Fischer |
| author_facet | Tobias Pantel Kevin Roedl Dominik Jarczak Yuanyuan Yu Daniel Peter Frings Barbara Sensen Hans Pinnschmidt Alexander Bernhardt Bastian Cheng Iris Lettow Manfred Westphal Patrick Czorlich Stefan Kluge Marlene Fischer |
| author_sort | Tobias Pantel |
| collection | DOAJ |
| 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% (<i>n</i> = 17/48) of patients with COVID-19 and in 16.7% (<i>n</i> = 26/156) of patients with ARDS attributable to factors other than COVID-19. COVID-19 (HR: 2.945; 95%; CI: 1.079–8.038; <i>p</i> = 0.035) and carboxyhemoglobin (HR: 0.330; 95%; CI: 0.135–0.806; <i>p</i> = 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. |
| first_indexed | 2024-03-10T03:36:19Z |
| format | Article |
| id | doaj.art-0b7af13c6b8249d6afda1cc9e9326cda |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T03:36:19Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0b7af13c6b8249d6afda1cc9e9326cda2023-11-23T11:42:34ZengMDPI AGJournal of Clinical Medicine2077-03832021-12-011112810.3390/jcm11010028Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational StudyTobias Pantel0Kevin Roedl1Dominik Jarczak2Yuanyuan Yu3Daniel Peter Frings4Barbara Sensen5Hans Pinnschmidt6Alexander Bernhardt7Bastian Cheng8Iris Lettow9Manfred Westphal10Patrick Czorlich11Stefan Kluge12Marlene Fischer13Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Anesthesiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyInstitute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment for Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, GermanyExtracorporeal 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% (<i>n</i> = 17/48) of patients with COVID-19 and in 16.7% (<i>n</i> = 26/156) of patients with ARDS attributable to factors other than COVID-19. COVID-19 (HR: 2.945; 95%; CI: 1.079–8.038; <i>p</i> = 0.035) and carboxyhemoglobin (HR: 0.330; 95%; CI: 0.135–0.806; <i>p</i> = 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.https://www.mdpi.com/2077-0383/11/1/28COVID-19extracorporeal membrane oxygenationintracerebral hemorrhagehemorrhagic strokeneurologic complicationsacute respiratory distress syndrome |
| spellingShingle | Tobias Pantel Kevin Roedl Dominik Jarczak Yuanyuan Yu Daniel Peter Frings Barbara Sensen Hans Pinnschmidt Alexander Bernhardt Bastian Cheng Iris Lettow Manfred Westphal Patrick Czorlich Stefan Kluge Marlene Fischer Association of COVID-19 with Intracranial Hemorrhage during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome: A 10-Year Retrospective Observational Study Journal of Clinical Medicine COVID-19 extracorporeal membrane oxygenation intracerebral hemorrhage hemorrhagic stroke neurologic complications acute respiratory distress syndrome |
| 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 | COVID-19 extracorporeal membrane oxygenation intracerebral hemorrhage hemorrhagic stroke neurologic complications acute respiratory distress syndrome |
| url | https://www.mdpi.com/2077-0383/11/1/28 |
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