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Published on: February 17, 2013
Association Between Cerebral Microbleeds and Neurological Outcomes in Patients Who Underwent Extracorporeal Membrane
Zhipeng Xu1, Jingchen Zhang1, Xing Fang1
1Department of Critical Care Medicine The First Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China.
Background:
Cerebral microbleeds (CMBs) are common and varied in patients receiving extracorporeal membrane oxygenation (ECMO). Here, the authors describe CMB findings in patients receiving ECMO and their association with clinical factors.
Methods And Results:
A total of 138 patients receiving ECMO were enrolled and categorized as venovenous and venoarterial. Blood coagulation profiles during ECMO support and Glasgow Coma Scale (GCS) scores within 7 days were recorded. Patients with CMBs exhibited prolonged activated clotting time (P<0.001), decreased fibrinogen levels (P<0.001), reduced platelet counts (P<0.001), and extended prothrombin time (P<0.001). A significant correlation (P<0.05) was observed between the presence of CMBs and most coagulation parameters among all patients. Patients with venoarterial ECMO had significantly higher activated partial thromboplastin time, activated clotting time, and prothrombin time compared with those with venovenous ECMO (all P<0.05). Patients with a less severe CMB burden exhibited higher GCS scores and better neurological injury outcomes at both 7 and 90 days. CMB burden in all patients with ECMO was significantly correlated (P<0.05) with most blood coagulation profiles and neurological injury.
Conclusions:
CMB burdens after ECMO are common, varied, and associated with a variety of clinical conditions. These findings may guide ECMO management.
Insights
Cerebral microbleeds (CMBs) are common in patients on extracorporeal membrane oxygenation (ECMO). CMBs correlate with coagulation issues and impact neurological outcomes, guiding ECMO management.
Area of Science:
- Neurology
- Critical Care Medicine
- Hematology
Background:
- Cerebral microbleeds (CMBs) are frequently observed in patients undergoing extracorporeal membrane oxygenation (ECMO).
- The variability and clinical associations of CMBs in this population require further investigation.
Purpose of the Study:
- To describe CMB findings in ECMO patients.
- To investigate the association between CMBs and clinical factors, including coagulation profiles and neurological outcomes.
Main Methods:
- Retrospective analysis of 138 patients undergoing ECMO (venovenous and venoarterial).
- Recording of blood coagulation profiles and Glasgow Coma Scale (GCS) scores.
- Correlation analysis between CMBs, coagulation parameters, and neurological outcomes.
Main Results:
- Patients with CMBs showed prolonged activated clotting time, decreased fibrinogen, reduced platelets, and extended prothrombin time.
- CMB presence correlated significantly with most coagulation parameters.
- Venoarterial ECMO was associated with higher activated partial thromboplastin time, activated clotting time, and prothrombin time compared to venovenous ECMO.
- Lower CMB burden correlated with higher GCS scores and better neurological outcomes at 7 and 90 days.
Conclusions:
- CMB burden after ECMO is common and associated with various clinical conditions.
- These findings highlight the importance of monitoring CMBs in ECMO patients.
- Understanding these associations may inform and improve ECMO management strategies.
