OR02-6
Neurological Complications of Veno-arterial Extracorporeal Membrane Oxygenation: A Single-Center Experience
Presenter
Mohamed Ramzi Almajed, MD, Henry Ford Hospital, Detroit, MI
Mohamed Ramzi Almajed, MD1, Austin Parsons, DO1, Jasmeet Kalsi, MD1, Al Muthanna Shadid, MD1, Mohamed Maki, MBBCh1, Crystal Jones, NP1, Celeste Williams, MD1, Herb D. Aronow, MD, MPH, FSCAI2, Diazo Tanaka, MD1, Hassan Nemeh, MD1, Brittany Fuller, MD3, Mohammad Alqarqaz, MD1, Gerald C. Koenig, MD, PhD, FSCAI3, Pedro Villablanca, MD1, Tiberio Frisoli, MD1, Brian O'Neill, MD1, Akshay Khandelwal, MD1, Jennifer Cowger, MD1, Gillian Grafton, MD4, Henry E. Kim, MD1, William W. O'Neill, MD, MSCAI3, Khaldoon Alaswad, M.D., FSCAI1 and Babar B Basir, DO, FSCAI3, (1)Henry Ford Hospital, Detroit, MI, (2)Henry Ford Health, Detroit, MI, (3)Henry Ford Health System, Detroit, MI, (4)Henry Ford Health, Plymouth, MI
Keywords: Cardiogenic Shock, Complications and Hemodynamic Support
Background
There has been increasing use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) over the past decade. Despite its increased use, neurological complications remain a significant source of morbidity and mortality..
Methods
A single-center retrospective analysis was performed. Patients who were managed with peripheral VA-ECMO between January 2018 to September 2022 at a tertiary center were included. Statistical analysis was performed with the Mann-Whitney U test or t-test for continuous variables and the Fisher’s exact test or chi-square test for categorical variables. Univariate and multivariate analyses were performed. Results
A total 244 patients underwent peripheral VA-ECMO. Survival 24-hours from decannulation was seen in 54% (n=132) of patients whereas death occurred in 46% (n=112) of patients. Stroke was seen in 14.8% (n=36) of patients; ischemic stroke rate was 8.2% (n=20) whereas hemorrhagic stroke rate was 6.6% (n=16). Mortality did not differ between patients who developed stroke compared to those who did not. Duration on VA-ECMO and hospital length of stays were also comparable between groups. Table 1 describes outcomes in the context of stroke.
Conclusions
VA-ECMO carries a considerable risk of neurological complications. Mortality and duration of hemodynamic support was not associated with stroke risk. Awareness regarding stroke risk is imperative in facilitating early identification and management.
