Posterior Segment Findings in Patients on Extracorporeal Membrane Oxygenation
Purpose: Extracorporeal membrane oxygenation (ECMO) is an established treatment modality for critically ill patients with cardiopulmonary failure, yet little is known of the ocular pathology in this population. The aim of this study is to characterize the posterior segment findings of ECMO patients....
Saved in:
| Published in: | Journal of vitreoretinal diseases (Print) Vol. 4; no. 6; pp. 490 - 493 |
|---|---|
| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Los Angeles, CA
SAGE Publications
01-11-2020
|
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Purpose:
Extracorporeal membrane oxygenation (ECMO) is an established
treatment modality for critically ill patients with cardiopulmonary failure,
yet little is known of the ocular pathology in this population. The aim of
this study is to characterize the posterior segment findings of ECMO
patients.
Methods:
This study is a retrospective analysis of 20 ECMO patients evaluated by
ophthalmology from September 2012 to May 2019 at a level 1 trauma center.
Comprehensive examinations assessed for intraocular pathology. Demographic
data, exam findings, and mortality were analyzed.
Results:
The sample size consisted of 20 patients; a majority were male
(75%), and mean age was 37.4 years
(interquartile range, 26.75-50 years). All patients received
ECMO for care of acute respiratory distress syndrome (ARDS).
Average duration of ECMO therapy was 9.6 ± 6.5 days.
Eleven (55%) patients had acute retinal pathology,
including Purtscher-like retinopathy (20%), intraocular
hemorrhage (50%), and septic chorioretinitis
(bacterial or fungal, 10%). Location of hemorrhage
included the retina (40%), vitreous
(30%), and optic disc (15%). Sixty
percent (n = 12) of patients were unable
to provide a subjective history on initial assessment. Ultimately, 5 out of
20 patients (25%) died of systemic illness during their
hospital stay.
Conclusion:
This study demonstrates high rates of retinal pathology, most commonly
vitreous and/or retinal hemorrhage alongside a Purtscher-like retinopathy.
This is likely secondary to complications of anticoagulation, microthrombi,
septicemia, and hemodynamic instability. We found a mortality rate slightly
lower than that of prior ECMO studies. Prospective studies with pre-ECMO and
post-ECMO fundus photography is warranted for better understanding of these
medically complex patients. |
|---|---|
| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 2474-1264 2474-1272 |
| DOI: | 10.1177/2474126420937172 |