Arterial Carbon Dioxide and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation.
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
01 12 2022
01 12 2022
Historique:
pubmed:
8
6
2022
medline:
10
12
2022
entrez:
7
6
2022
Statut:
ppublish
Résumé
Acute brain injury (ABI) occurs frequently in patients receiving venoarterial extracorporeal membrane oxygenation (VA-ECMO). We examined the association between peri-cannulation arterial carbon dioxide tension (PaCO 2 ) and ABI with granular blood gas data. We retrospectively analyzed adult patients who underwent VA-ECMO at a tertiary care center with standardized neuromonitoring. Pre- and post-cannulation PaCO 2 were defined as the mean of all PaCO 2 values in the 12 hours before and after cannulation, respectively. Peri-cannulation PaCO 2 drop (∆PaCO 2 ) equaled pre- minus post-cannulation PaCO 2 . ABI included intracranial hemorrhage (ICH), ischemic stroke, hypoxic-ischemic brain injury, cerebral edema, seizure, and brain death. Univariable logistic regression analysis was performed for the presence of ABI. Out of 129 VA-ECMO patients (median age = 60, 63% male), 43 (33%) patients experienced ABI. Patients had a median of 11 (interquartile range: 8-14) peri-cannulation PaCO 2 values. Comparing patients with and without ABI, pre-cannulation (39 vs. 42 mm Hg; p = 0.38) and post-cannulation (37 vs. 36 mm Hg; p = 0.82) PaCO 2 were not different. However, higher pre-cannulation PaCO 2 (odds ratio [OR] = 2.10; 95% confidence interval [CI] = 1.10-4.00; p = 0.02) and larger ∆PaCO 2 (OR = 2.69; 95% CI = 1.18-6.13; p = 0.02) were associated with ICH. In conclusion, in a cohort with granular arterial blood gas (ABG) data and a standardized neuromonitoring protocol, higher pre-cannulation PaCO 2 and larger ∆PaCO 2 were associated with increased prevalence of ICH.
Identifiants
pubmed: 35671442
doi: 10.1097/MAT.0000000000001699
pii: 00002480-202212000-00015
pmc: PMC9477972
mid: NIHMS1790909
doi:
Substances chimiques
Carbon Dioxide
142M471B3J
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1501-1507Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL157610
Pays : United States
Organisme : NINDS NIH HHS
ID : L30 NS119233
Pays : United States
Informations de copyright
Copyright © ASAIO 2022.
Déclaration de conflit d'intérêts
Disclosure: B.L.S. received research funding from the Alpha Omega Alpha Honor Medical Society during the conduct of this study. S-M.C. is supported by NHLBI (1K23HL157610). The other authors have no conflicts of interest to report.
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