title: Duration of ECMO Is an Independent Predictor of Intracranial Hemorrhage Occurring During ECMO Support.
abstract: We assessed the incidence and predictors of intracranial hemorrhage (ICH) occurring during extracorporeal membrane oxygenation (ECMO) support. Of 154 patients who received ECMO, 12 (7.8%) developed ICH. Patients with ICH had a longer ECMO duration (9.41 vs. 5.37 days, p = 0.007), and higher activated clotting time (activated clotting time, p= 0.016). They also experienced higher frequency of bleeding at other sites (p = 0.017) and required more platelet transfusion (p = 0.016). Multivariate analysis showed that a longer ECMO duration (odds ratio [OR] = 1.074, 95% confidence interval [CI] = 1.005-1.148, p = 0.035) is independently associated with the risk of ICH. We recommend routine neurological checks, monitoring of coagulation parameters, and attempt earlier rather than late weaning from ECMO whenever feasible.
authors.affiliation: From the *Internal Medicine Department, Mercy Medical Center, Clinton, Iowa; †Division of Pulmonary, Critical Care, Sleep and Allergy, University of Miami, Miller School of Medical, Miami, Florida; ‡Section of Pulmonary, Department of Medicine, Miami VA Medical Center, Miami, Florida; §Tampa General Hospital, Tampa, Florida; ¶Department of Anesthesiology, TEAMHealth, Tampa, Florida; and ‖University of South Florida, Tampa, Florida.
authors.forename: Hesham R
authors.initials: HR
authors.lastname: Omar
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mirsaeidi
authors.forename: Devanand
authors.initials: D
authors.lastname: Mangar
authors.forename: Enrico M
authors.initials: EM
authors.lastname: Camporesi
mesh_terms: D000328:Adult; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors