PMID- 36052306
OWN - NLM
STAT- MEDLINE
DCOM- 20220907
LR  - 20220907
IS  - 1742-1241 (Electronic)
IS  - 1368-5031 (Print)
IS  - 1368-5031 (Linking)
VI  - 2022
DP  - 2022
TI  - Transcranial Doppler Ultrasound for Monitoring the Cerebral Hemodynamic Changes 
      and Prognosticating Outcomes in Venoarterial Extracorporeal Membrane-Oxygenated 
      Patients.
PG  - 2912477
LID - 10.1155/2022/2912477 [doi]
LID - 2912477
AB  - OBJECTIVE: Patients receiving venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) support may have cerebral hemodynamic changes whose impact on patient 
      outcome are not fully elucidated. This study aims to evaluate the correlation 
      between cerebral hemodynamic changes and prognostic outcome in patients during 
      VA-ECMO. METHODS: Transcranial Doppler (TCD) ultrasound examination was performed 
      to attain the systolic velocity (Vs), diastolic velocity (Vd), mean velocity 
      (Vm), and pulsatility index (PI) of patients undergoing VA-ECMO. Cardiac 
      ultrasound was also performed to assess the correlation between the left 
      ventricular outflow tract velocity time integral (LVOT VTI), left ventricular 
      ejection fraction (LVEF), and middle cerebral artery (MCA) with the systolic 
      peak. Moreover, we assessed the predictive value of LVOT VTI and LVEF in patients 
      with the systolic peak. Patients were divided into survival and death groups 
      according to the 28-day survival period. Clinical data were compared between the 
      two groups to investigate the effects of cerebral hemodynamic changes on the 
      prognosis of VA-ECMO patients. RESULTS: We found that the patient's LVOT VTI and 
      LVEF had high predictive values for the systolic peak of the right middle 
      cerebral artery. The initial LVEF, Vs, Vd and PI, and lactate level as well as 
      the MODS incidence rate difference were significantly different between the 
      survival and death groups. In addition, the results showed that the initial Vs 
      value was an independent risk factor for the prognosis of patients undergoing 
      VA-ECMO. CONCLUSIONS: Cerebral hemodynamic changes may occur in patients 
      supported by VA-ECMO. In addition, a poor cerebral arterial pulsatile blood flow 
      was closely correlated with an unfavorable outcome in these patients.
CI  - Copyright (c) 2022 Man Wang et al.
FAU - Wang, Man
AU  - Wang M
AUID- ORCID: 0000-0001-6507-2142
AD  - Emergency Department, Guigang City People's Hospital, Guigang 537100, Guangxi 
      Zhuang Autonomous Region, China.
FAU - Li, Le
AU  - Li L
AUID- ORCID: 0000-0003-2499-4380
AD  - Emergency Department, Guigang City People's Hospital, Guigang 537100, Guangxi 
      Zhuang Autonomous Region, China.
FAU - Tan, Yi-Dong
AU  - Tan YD
AUID- ORCID: 0000-0002-4966-0750
AD  - Emergency Department, Guigang City People's Hospital, Guigang 537100, Guangxi 
      Zhuang Autonomous Region, China.
LA  - eng
PT  - Journal Article
DEP - 20220822
PL  - India
TA  - Int J Clin Pract
JT  - International journal of clinical practice
JID - 9712381
SB  - IM
MH  - Cerebrovascular Circulation/physiology
MH  - Hemodynamics
MH  - Humans
MH  - Stroke Volume
MH  - *Ultrasonography, Doppler, Transcranial
MH  - *Ventricular Function, Left
PMC - PMC9423977
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2022/09/03 06:00
MHDA- 2022/09/08 06:00
PMCR- 2022/08/22
CRDT- 2022/09/02 02:49
PHST- 2022/05/23 00:00 [received]
PHST- 2022/08/05 00:00 [accepted]
PHST- 2022/09/02 02:49 [entrez]
PHST- 2022/09/03 06:00 [pubmed]
PHST- 2022/09/08 06:00 [medline]
PHST- 2022/08/22 00:00 [pmc-release]
AID - 10.1155/2022/2912477 [doi]
PST - epublish
SO  - Int J Clin Pract. 2022 Aug 22;2022:2912477. doi: 10.1155/2022/2912477. 
      eCollection 2022.