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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Special considerations and pitfalls for intracerebral bleeding followed COVID-19 case treated by ECMO
Wael Osman Amer1,2, Hussein Awad El Gharieb1,2, Zakaria Ahmed1,2
1Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Insights
COVID-19 patients requiring extracorporeal membrane oxygenation (ECMO) face a high risk of intracerebral bleeding. This complication stems from factors like ACE2 receptor interactions, hypertension, and anticoagulant use.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Neurology
Background:
- COVID-19 can cause acute respiratory distress syndrome (ARDS), a life-threatening condition.
- Extracorporeal membrane oxygenation (ECMO) is a vital treatment for severe ARDS.
- Bleeding, particularly intracerebral hemorrhage, is a significant complication in ECMO patients.
Purpose of the Study:
- To review the risk factors for intracerebral bleeding in COVID-19 patients undergoing ECMO.
- To highlight the multifactorial nature of bleeding complications in this patient population.
Main Methods:
- Literature review focusing on COVID-19, ECMO, and intracerebral hemorrhage.
- Analysis of contributing factors including viral mechanisms, patient physiology, and therapeutic interventions.
Main Results:
- COVID-19 patients on ECMO exhibit increased risk for intracerebral bleeding.
- Key contributing factors include ACE2 receptor interactions, hypertension, hypercoagulability, immune dysregulation, DIC, and anticoagulant therapy.
Conclusions:
- Intracerebral bleeding is a critical concern for COVID-19 patients on ECMO.
- Understanding these risk factors is essential for optimizing patient management and mitigating complications.
Abstract:
COVID-19, or coronavirus infection, is an acute respiratory illness caused by the corona virus that can develop into a life-threatening form of ARDS. Extracorporeal membrane oxygenation (ECMO) is a highly effective treatment for life-threatening instances. One of the many complications associated with ECMO was bleeding. COVID patients are at risk for intracerebral bleeding due to several factors, including the drug's action on ACE2 receptors, leading to hypertension, as well as hypercoagulability, dysregulated immune response, DIC, and the use of anticoagulants.
