PMID- 37556554
OWN - NLM
STAT- MEDLINE
DCOM- 20231204
LR  - 20240207
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Print)
IS  - 1058-2916 (Linking)
VI  - 69
IP  - 12
DP  - 2023 Dec 1
TI  - Trends on Near-Infrared Spectroscopy Associated With Acute Brain Injury in 
      Venoarterial Extracorporeal Membrane Oxygenation.
PG  - 1083-1089
LID - 10.1097/MAT.0000000000002032 [doi]
AB  - We aimed to determine the association between cerebral regional oxygen saturation 
      (rSO 2 ) trends from cerebral near-infrared spectroscopy (cNIRS) and acute brain 
      injury (ABI) in adult venoarterial extracorporeal membrane oxygenation (VA-ECMO) 
      patients. ABI was defined as intracranial hemorrhage, ischemic stroke, hypoxic 
      ischemic brain injury, or brain death during ECMO. rSO 2 values were collected 
      from left and right cerebral oximetry sensors every hour from ECMO cannulation. 
      Cerebral desaturation was defined as consecutive hours of rSO 2 < 40%. rSO 2 
      asymmetry was determined by (a) averaging left/right rSO 2 difference over the 
      entire ECMO run; (b) consecutive hours of rSO 2 asymmetry. Sixty-nine VA-ECMO 
      patients (mean age 56 years, 65% male) underwent cNIRS. Eighteen (26%) 
      experienced ABI. When the mean rSO 2 asymmetry was >8% there was significantly 
      increased odds of ABI (aOR = 39.4; 95% CI = 4.1-381.4). Concurrent rSO 2 < 40% 
      and rSO 2 asymmetry >10% for >10 consecutive hours (asymmetric desaturation) was 
      also significantly associated with ABI (aOR = 5.2; 95% CI = 1.2-22.2), but 
      neither criterion alone were. Mean rSO 2 asymmetry>8% exhibited 39% sensitivity 
      and 98% specificity for detecting ABI, with an area under the curve (AUC) of 
      0.86, and asymmetric desaturation had 33% sensitivity and 88% specificity, with 
      an AUC of 0.72. These trends on NIRS monitoring may help detect ABI in VA-ECMO 
      patients.
CI  - Copyright (c) ASAIO 2023.
FAU - Zhao, David
AU  - Zhao D
AD  - From the Division of Neurosciences Critical Care, Departments of Neurology, 
      Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
FAU - Shou, Benjamin L
AU  - Shou BL
AUID- ORCID: 0000-0003-2825-3301
AD  - Cardiovascular Surgery Intensive Care Unit, Department of Surgery, Johns Hopkins 
      Hospital, Baltimore, Maryland, USA.
FAU - Caturegli, Giorgio
AU  - Caturegli G
AUID- ORCID: 0000-0001-6508-7096
AD  - From the Division of Neurosciences Critical Care, Departments of Neurology, 
      Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
FAU - Whitman, Glenn J R
AU  - Whitman GJR
AD  - Cardiovascular Surgery Intensive Care Unit, Department of Surgery, Johns Hopkins 
      Hospital, Baltimore, Maryland, USA.
FAU - Kim, Bo Soo
AU  - Kim BS
AD  - Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns 
      Hopkins University School of Medicine, Baltimore, Maryland, USA.
FAU - Cho, Sung-Min
AU  - Cho SM
AUID- ORCID: 0000-0002-5132-0958
AD  - From the Division of Neurosciences Critical Care, Departments of Neurology, 
      Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins University 
      School of Medicine, Baltimore, Maryland, USA.
CN  - Herald Investigators
LA  - eng
GR  - K23 HL157610/HL/NHLBI NIH HHS/United States
GR  - L30 HL165486/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20230809
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Female
MH  - Oximetry
MH  - Oxygen
MH  - *Extracorporeal Membrane Oxygenation/adverse effects/methods
MH  - Spectroscopy, Near-Infrared
MH  - Cerebrovascular Circulation
MH  - *Brain Injuries/etiology
PMC - PMC10843160
MID - NIHMS1933336
COIS- Disclosure: The authors have no conflicts of interest to report.
EDAT- 2023/08/09 18:42
MHDA- 2023/12/04 12:41
PMCR- 2024/02/05
CRDT- 2023/08/09 14:03
PHST- 2023/12/04 12:41 [medline]
PHST- 2023/08/09 18:42 [pubmed]
PHST- 2023/08/09 14:03 [entrez]
PHST- 2024/02/05 00:00 [pmc-release]
AID - 00002480-990000000-00289 [pii]
AID - 10.1097/MAT.0000000000002032 [doi]
PST - ppublish
SO  - ASAIO J. 2023 Dec 1;69(12):1083-1089. doi: 10.1097/MAT.0000000000002032. Epub 
      2023 Aug 9.