title: Effects of venovenous extracorporeal membrane oxygenation on cerebral oxygenation in hypercapnic ARDS.
abstract: Extracorporeal membrane oxygenation (ECMO) is increasingly used in ARDS patients with hypoxemia and/or severe hypercapnia refractory to conventional treatment strategies. However, it is associated with severe intracranial complications, e.g. ischemic or hemorrhagic stroke. The arterial carbon dioxide partial pressure (PaCO2) is one of the main determinants influencing cerebral blood flow and oxygenation. Since CO2 removal is highly effective during ECMO, reduction of CO2 may lead to alterations in cerebral perfusion. We report on the variations of cerebral oxygenation during the initiation period of ECMO treatment in a patient with hypercapnic ARDS, which may partly explain the findings of ischemic and/or hemorrhagic complications in conjunction with ECMO.
authors.affiliation: University of Würzburg, Würzburg, Germany.
authors.forename: R M
authors.initials: RM
authors.lastname: Muellenbach
authors.forename: C
authors.initials: C
authors.lastname: Kilgenstein
authors.forename: P
authors.initials: P
authors.lastname: Kranke
authors.forename: J
authors.initials: J
authors.lastname: Küstermann
authors.forename: M
authors.initials: M
authors.lastname: Kredel
authors.forename: N
authors.initials: N
authors.lastname: Roewer
authors.forename: R I
authors.initials: RI
authors.lastname: Ernestus
authors.forename: T
authors.initials: T
authors.lastname: Westermaier
mesh_terms: D002245:Carbon Dioxide / Q000097:blood; D002560:Cerebrovascular Circulation; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000628:therapy*; D008875:Middle Aged; D012128:Respiratory Distress Syndrome / Q000097:blood / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide
keywords: ARDS; ECMO; extracorporeal CO2 removal; interventional lung assist; near infrared spectroscopy