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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.
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.
  • Pantel T; Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Roedl K; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Jarczak D; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Yu Y; Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Frings DP; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Sensen B; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Pinnschmidt H; Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Bernhardt A; Department for Cardiovascular Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Cheng B; Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Lettow I; Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Westphal M; Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Czorlich P; Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Kluge S; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
  • Fischer M; Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
J Clin Med ; 11(1)2021 Dec 22.
Article in English | MEDLINE | ID: covidwho-1580658
ABSTRACT
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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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prognostic study Language: English Year: 2021 Document Type: Article Affiliation country: Jcm11010028

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Etiology study / Observational study / Prognostic study Language: English Year: 2021 Document Type: Article Affiliation country: Jcm11010028