Cerebral Outcome in Adult Patients Treated With Extracorporeal Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) carries a high risk of brain injury. The aim of this study was to determine the cerebral status in 28 adult survivors on average 5.0 (range, 0.5 to 12) years after ECMO treatment for severe cardiorespiratory failure. All 28 patients were investigated at our...

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Published in:	The Annals of thoracic surgery Vol. 81; no. 4; pp. 1401 - 1406
Main Authors:	Risnes, Ivar, Wagner, Kari, Nome, Terje, Sundet, Kjetil, Jensen, Jorun, Hynås, Inger Annette, Ueland, Thor, Pedersen, Thore, Svennevig, Jan Ludvig
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-04-2006 Elsevier Science
Subjects:	Adolescent Adult Biological and medical sciences Brain Diseases - diagnosis Brain Diseases - epidemiology Brain Diseases - etiology Extracorporeal Membrane Oxygenation - adverse effects Female Follow-Up Studies Humans Male Medical sciences Middle Aged Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the respiratory system 27 Human Prognosis Treatment Respiratory disease Surgery Adult Evolution Patient Membrane Thorax Oxygenation Encephalon
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Summary:	Extracorporeal membrane oxygenation (ECMO) carries a high risk of brain injury. The aim of this study was to determine the cerebral status in 28 adult survivors on average 5.0 (range, 0.5 to 12) years after ECMO treatment for severe cardiorespiratory failure. All 28 patients were investigated at our institution. A comprehensive assessment protocol included a medical history, physical examination, neuropsychological assessment, electroencephalography, and neuroradiologic assessment. All patients were ambulant unaided, and 43% were without any clinical findings. Impaired neuropsychological performance was found in 41%, neuroradiologic findings in 52%, and a pathologic electroencephalogram in 41% of the patients. There was a significant correlation between the cognitive outcome and neuroradiologic findings. The incidence of neuroradiologic findings (cerebral infarction, microemboli or hemorrhage) was significantly higher in the venoarterial group compared with the venovenous group (75% versus 17%). There was no correlation between the type of ECMO and neuropsychological impairment. Electroencephalography findings did not correlate with neuropsychological performance, nor with the neuroradiologic findings. Late cerebral sequelae were frequently seen in patients treated on venoarterial ECMO. A significant correlation was found between cognitive impairment and neuroradiologic findings.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0003-4975 1552-6259
DOI:	10.1016/j.athoracsur.2005.10.008