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1000 Titel
  • Clinical management and outcome of adult patients with extracorporeal life support device–associated intracerebral hemorrhage—a neurocritical perspective and grading
1000 Autor/in
  1. Prinz, Vincent |
  2. Manekeller, Lisa |
  3. Menk, Mario |
  4. Hecht, Nils |
  5. Weber-Carstens, Steffen |
  6. Vajkoczy, Peter |
  7. Finger, Tobias |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-01-23
1000 Erschienen in
1000 Quellenangabe
  • 44(5):2879-2888
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s10143-020-01471-4 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8490251/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Intracerebral hemorrhage (ICH) is a devastating complication in patients treated with extracorporeal membrane oxygenation (ECMO) due to respiratory or cardiac issues. Neurosurgical evaluation and management of such cases has only insufficiently been studied. We conducted a retrospective, cohort study of adult patients treated with ECMO between January 2007 and January 2017 in a tertiary healthcare center. Demographics, clinical data, coagulation status, ICH characteristics, and treatment modalities were analyzed. The primary outcome parameter was defined as mortality caused by ICH during ECMO. 525 patients with ECMO therapy were eligible for analysis. An overall incidence for any type of intracranial bleeding of 12.3% was found. Small hemorrhages accounted for 6.4% and acute subdural and epidural hematoma for 1.2%. Twenty-four (4.6%) patients developed ICH, and 11 patients (46%) died due to the ICH. Mortality was significantly higher in patients with larger ICH volumes (86.8 ± 34.8 ml vs 9.9 ± 20.3 ml, p < 0.001), intraventricular hemorrhage (83% vs 8%, p = 0.01), and a fluid level inside the ICH (75% vs 31%, p = 0.04). All patients were classified according to the bleeding pattern on the initial CT scan into 3 types. Patients with type 1 bleeding were statistically more likely to die (p < 0.001). In 15 out of 24 patients (63%), correction of the coagulation status was possible within 12 h after ICH onset. Seven out of 9 patients (78%) without early coagulation correction died compared to 2 out of 15 patients (13%), in whom early coagulation correction was successful (p = 0.01). This is the first study evaluating the course and management of patients experiencing an ICH under ECMO therapy and establishing an ICH classification based on the bleeding patterns. Early correction of the coagulation is of paramount importance in the treatment of these patients.
1000 Sacherschließung
lokal Outcome
lokal Classification
lokal Adult [MeSH]
lokal Humans [MeSH]
lokal Retrospective Studies [MeSH]
lokal Extracorporeal Membrane Oxygenation/adverse effects [MeSH]
lokal Cohort Studies [MeSH]
lokal Intracranial Hemorrhages/etiology [MeSH]
lokal Original Article
lokal Cerebral Hemorrhage/therapy [MeSH]
lokal Intracerebral hemorrhage
lokal Coagulation
lokal ECMO
lokal Extracorporeal membrane oxygenation
lokal Surgery
lokal Intracranial Hemorrhages/therapy [MeSH]
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/UHJpbnosIFZpbmNlbnQ=|https://frl.publisso.de/adhoc/uri/TWFuZWtlbGxlciwgTGlzYQ==|https://frl.publisso.de/adhoc/uri/TWVuaywgTWFyaW8=|https://frl.publisso.de/adhoc/uri/SGVjaHQsIE5pbHM=|https://frl.publisso.de/adhoc/uri/V2ViZXItQ2Fyc3RlbnMsIFN0ZWZmZW4=|https://orcid.org/0000-0003-4350-392X|https://frl.publisso.de/adhoc/uri/RmluZ2VyLCBUb2JpYXM=
1000 Hinweis
  • DeepGreen-ID: 285ddaa9ee804bc39f1b085c04ec8774 ; metadata provieded by: DeepGreen (https://www.oa-deepgreen.de/api/v1/), LIVIVO search scope life sciences (http://z3950.zbmed.de:6210/livivo), Crossref Unified Resource API (https://api.crossref.org/swagger-ui/index.html), to.science.api (https://frl.publisso.de/), ZDB JSON-API (beta) (https://zeitschriftendatenbank.de/api/), lobid - Dateninfrastruktur für Bibliotheken (https://lobid.org/resources/search)
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1000 @id frl:6448917.rdf
1000 Erstellt am 2023-05-04T10:44:35.502+0200
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1000 Zuletzt bearbeitet Fri Oct 20 23:55:28 CEST 2023
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