PMID- 33593649
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20220531
IS  - 1532-8422 (Electronic)
IS  - 1053-0770 (Linking)
VI  - 35
IP  - 7
DP  - 2021 Jul
TI  - Acute Brain Injury in Postcardiotomy Shock Treated With Venoarterial 
      Extracorporeal Membrane Oxygenation.
PG  - 1989-1996
LID - S1053-0770(21)00074-4 [pii]
LID - 10.1053/j.jvca.2021.01.037 [doi]
AB  - OBJECTIVE: Acute brain injury (ABI) is common in venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO). One of the most common indications for use of 
      VA-ECMO is postcardiotomy shock (PCS). The authors aimed to characterize the 
      prevalence of ABI and its association with outcomes in this population. DESIGN: 
      prospective observational. SETTING: Single-center tertiary care university 
      hospital. PARTICIPANTS: Fifty-two consecutive patients treated for PCS with 
      VA-ECMO from November 2017 to March 2020. INTERVENTIONS: None. MEASUREMENTS AND 
      MAIN RESULTS: The median age of patients was 64 (interquartile range 44-84), 62% 
      were male. Of 52 PCS patients treated with extracorporeal membrane oxygenation, 
      38% (n = 20) experienced acute brain injury. Ischemic stroke was the most common 
      (n = 13, 25%). Patients with central versus peripheral cannulation experienced 
      more ischemic and hemorrhagic strokes (8% v 38%, p = 0.04). Patients with 
      intracardiac thrombus experienced more brain injury (n = 4, 8% p = 0.02). The 
      in-hospital mortality in patients with brain injury was 90% (n = 18/20) compared 
      to 78% (n = 25/32) in patients without brain injury. CONCLUSIONS: ABI is common 
      in postcardiotomy VA-ECMO and associated with worse outcome. Patients with 
      central recanalization experienced the majority of acute strokes. Intracardiac 
      thrombus was significantly associated with acute brain injury.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Wilcox, Christopher
AU  - Wilcox C
AD  - Department of Neurosciences, Mercy Hospital of Buffalo, Buffalo, NY.
FAU - Etchill, Eric
AU  - Etchill E
AD  - Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University 
      School of Medicine, Baltimore, MD.
FAU - Giuliano, Katherine
AU  - Giuliano K
AD  - Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University 
      School of Medicine, Baltimore, MD.
FAU - Mayasi, Yunis
AU  - Mayasi Y
AD  - Neuroscience Critical Care, Departments of Neurology, Neurosurgery, 
      Anesthesiology and Critical Care Medicine, Johns Hopkins University School of 
      Medicine, Baltimore, MD; Department of Neurocritical Care, Avera Health, Sioux 
      Falls, SD.
FAU - Gusdon, Aaron M
AU  - Gusdon AM
AD  - Neuroscience Critical Care, Departments of Neurology, Neurosurgery, 
      Anesthesiology and Critical Care Medicine, Johns Hopkins University School of 
      Medicine, Baltimore, MD; Department of Neurosurgery, University of Texas Health 
      Science Center, Houston, TX.
FAU - Cho I, Chun Woo
AU  - Cho I CW
AD  - Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University 
      School of Medicine, Baltimore, MD.
FAU - Kim, Bo Soo
AU  - Kim BS
AD  - Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University 
      School of Medicine, Baltimore, MD.
FAU - Bush, Errol L
AU  - Bush EL
AD  - Division of Thoracic Surgery, D epartment of Surgery, Heart, and Vascular 
      Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
FAU - Geocadin, Romergryko G
AU  - Geocadin RG
AD  - Neuroscience Critical Care, Departments of Neurology, Neurosurgery, 
      Anesthesiology and Critical Care Medicine, Johns Hopkins University School of 
      Medicine, Baltimore, MD.
FAU - Whitman, Glenn J
AU  - Whitman GJ
AD  - Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University 
      School of Medicine, Baltimore, MD.
FAU - Cho, Sung-Min
AU  - Cho SM
AD  - Neuroscience Critical Care, Departments of Neurology, Neurosurgery, 
      Anesthesiology and Critical Care Medicine, Johns Hopkins University School of 
      Medicine, Baltimore, MD. Electronic address: csungmi1@jhmi.ed.
LA  - eng
GR  - L30 NS119233/NS/NINDS NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
DEP - 20210125
PL  - United States
TA  - J Cardiothorac Vasc Anesth
JT  - Journal of cardiothoracic and vascular anesthesia
JID - 9110208
SB  - IM
CIN - J Cardiothorac Vasc Anesth. 2021 Jul;35(7):1997-1998. PMID: 33838981
MH  - *Brain Injuries/diagnostic imaging/epidemiology/etiology
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Prospective Studies
MH  - *Shock
MH  - Shock, Cardiogenic/epidemiology/etiology/therapy
OTO - NOTNLM
OT  - VA ECMO
OT  - acute brain injury
OT  - extracorporeal membrane oxygenation
OT  - neurologic complication
OT  - post-cardiotomy shock
EDAT- 2021/02/18 06:00
MHDA- 2021/07/02 06:00
CRDT- 2021/02/17 05:42
PHST- 2020/12/27 00:00 [received]
PHST- 2021/01/15 00:00 [revised]
PHST- 2021/01/19 00:00 [accepted]
PHST- 2021/02/18 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2021/02/17 05:42 [entrez]
AID - S1053-0770(21)00074-4 [pii]
AID - 10.1053/j.jvca.2021.01.037 [doi]
PST - ppublish
SO  - J Cardiothorac Vasc Anesth. 2021 Jul;35(7):1989-1996. doi: 
      10.1053/j.jvca.2021.01.037. Epub 2021 Jan 25.