PMID- 32474793
OWN - NLM
STAT- MEDLINE
DCOM- 20210412
LR  - 20220216
IS  - 1619-0904 (Electronic)
IS  - 1434-7229 (Print)
IS  - 1434-7229 (Linking)
VI  - 23
IP  - 4
DP  - 2020 Dec
TI  - Spinal cord infarction during venoarterial-extracorporeal membrane oxygenation 
      support.
PG  - 388-393
LID - 10.1007/s10047-020-01179-8 [doi]
AB  - Spinal cord infarction (SCI) is a rare disease among central nervous system 
      vascular diseases. Only a little is known about venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO)-related SCI. Retrospective observational study 
      conducted, from 2006 to 2019, in a tertiary referral center on patients who 
      developed VA-ECMO-related neurovascular complications, focusing on SCI. During 
      this period, among the 1893 patients requiring VA-ECMO support, 112 (5.9%) 
      developed an ECMO-related neurovascular injury: 65 (3.4%) ischemic strokes, 40 
      (2.1%) intracranial bleeding, one cerebral thrombophlebitis (0.05%) and 6 (0.3%) 
      spinal cord infarction. Herein, we report a series of six patients with 
      refractory cardiogenic shock or cardiac arrest receiving circulatory support with 
      VA-ECMO who developed subsequent SCI during ECMO course, confirmed by spine MRI 
      after ECMO withdrawal. All six patients had long-term neurological disabilities. 
      VA-ECMO-related SCI is a rare but catastrophic complication. Its diagnosis is 
      usually delayed due to sedation requirement and/or ICU acquired weakness after 
      sedation withdrawal, leading to difficulties in monitoring their neurological 
      status. Even if no specific treatment exist for SCI, its prompt diagnosis is 
      mandatory, to prevent secondary spine insults of systemic origin. Based on these 
      results, we suggest that daily sedation interruption and neurological exam of the 
      lower limbs should be performed in all VA-ECMO patients. Large registries are 
      mandatory to determine VA-ECMO-related SCI risk factor and potential therapy.
FAU - Le Guennec, Loic
AU  - Le Guennec L
AUID- ORCID: 0000-0001-8146-6256
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France. loic.leguennec@yahoo.fr.
FAU - Shor, Natalia
AU  - Shor N
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France.
FAU - Levy, Bruno
AU  - Levy B
AD  - Universite de Lorraine, Nancy, France.
FAU - Lebreton, Guillaume
AU  - Lebreton G
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France.
FAU - Leprince, Pascal
AU  - Leprince P
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France.
FAU - Combes, Alain
AU  - Combes A
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France.
FAU - Dormont, Didier
AU  - Dormont D
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France.
FAU - Luyt, Charles-Edouard
AU  - Luyt CE
AD  - Hopital Universitaire Pitie Salpetriere, Paris, France.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20200530
PL  - Japan
TA  - J Artif Organs
JT  - Journal of artificial organs : the official journal of the Japanese Society for 
      Artificial Organs
JID - 9815648
SB  - IM
MH  - Adult
MH  - Extracorporeal Membrane Oxygenation/*adverse effects
MH  - Heart Arrest/*therapy
MH  - Humans
MH  - Infarction/*etiology
MH  - Male
MH  - Middle Aged
MH  - Registries
MH  - Retrospective Studies
MH  - Shock, Cardiogenic/*therapy
MH  - Spinal Cord/*blood supply
PMC - PMC7260457
OTO - NOTNLM
OT  - Extracorporeal membrane oxygenation
OT  - Intra-aortic balloon pump
OT  - Neurological examination
OT  - Secondary spine insults of systemic origin
OT  - Sedation withdrawal
OT  - Spinal cord infarct
COIS- The other authors have no conflicts of interest to declare in relationship with 
      this manuscript.
EDAT- 2020/06/01 06:00
MHDA- 2021/04/13 06:00
PMCR- 2020/05/30
CRDT- 2020/06/01 06:00
PHST- 2019/12/31 00:00 [received]
PHST- 2020/04/28 00:00 [accepted]
PHST- 2020/06/01 06:00 [pubmed]
PHST- 2021/04/13 06:00 [medline]
PHST- 2020/06/01 06:00 [entrez]
PHST- 2020/05/30 00:00 [pmc-release]
AID - 10.1007/s10047-020-01179-8 [pii]
AID - 1179 [pii]
AID - 10.1007/s10047-020-01179-8 [doi]
PST - ppublish
SO  - J Artif Organs. 2020 Dec;23(4):388-393. doi: 10.1007/s10047-020-01179-8. Epub 
      2020 May 30.