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@article{Arachchillage:2018:10.1055/s-0038-1636840,
author = {Arachchillage, DRJ and Passariello, M and Laffan, M and Aw, TC and Owen, L and Banya, W and Trimlett, R and Morgan, C and Patel, BV and Pepper, J and Ledot, S},
doi = {10.1055/s-0038-1636840},
journal = {Seminars in Thrombosis and Hemostasis},
pages = {276--286},
title = {Intracranial haemorrhage and early mortality in patients receiving extracorporeal membrane oxygenation for severe respiratory failure},
url = {http://dx.doi.org/10.1055/s-0038-1636840},
volume = {44},
year = {2018}
}

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TY  - JOUR
AB  - Intracranial hemorrhage (ICH) is a serious complication in patients receiving veno-venous extracorporeal membrane oxygenation (VV-ECMO) and is associated with high mortality. It is unknown whether ICH may be a consequence of the ECMO or of an underlying disease. The authors first aimed to assess the incidence of ICH at initiation and during the course of VV-ECMO and its associated mortality. The second aim was to identify clinical and laboratory measures that could predict the development of ICH in severe respiratory failure. Data were collected from a total number of 165 patients receiving VV-ECMO from January, 2012 to December, 2016 in a single tertiary center and treated according to a single protocol. Only patients who had a brain computed tomography within 24 hours of initiation of ECMO (n = 149) were included for analysis. The prevalence and incidence of ICH at initiation and during the course of VV-ECMO (at median 9 days) were 10.7% (16/149) and 5.2% (7/133), respectively. Thrombocytopenia and reduced creatinine clearance (CrCL) were independently associated with increased risk of ICH on admission; odds ratio (95% confidence interval): 22.6 (2.6–99.5), and 10.8 (5.6–16.2). Only 30-day (not 180-day) mortality was significantly higher in patients with ICH on admission versus those without (37.5% [6/16] vs 16.4% [22/133]; p = 0.03 and 43.7% [7/16] vs 26.3% [35/133]; p = 0.15, respectively). Reduced CrCL and thrombocytopenia were associated with ICH at initiation of VV-ECMO. The higher incidence of ICH at initiation suggests it is more closely related to the severity of the underlying lung injury than to the VV-ECMO itself. ICH at VV-ECMO initiation was associated with early mortality.
AU  - Arachchillage,DRJ
AU  - Passariello,M
AU  - Laffan,M
AU  - Aw,TC
AU  - Owen,L
AU  - Banya,W
AU  - Trimlett,R
AU  - Morgan,C
AU  - Patel,BV
AU  - Pepper,J
AU  - Ledot,S
DO  - 10.1055/s-0038-1636840
EP  - 286
PY  - 2018///
SN  - 0094-6176
SP  - 276
TI  - Intracranial haemorrhage and early mortality in patients receiving extracorporeal membrane oxygenation for severe respiratory failure
T2  - Seminars in Thrombosis and Hemostasis
UR  - http://dx.doi.org/10.1055/s-0038-1636840
UR  - http://hdl.handle.net/10044/1/58173
VL  - 44
ER  -

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