World's Largest Resource for Cardiovascular Perfusion

Perfusion NewswireECMO ZoneArterial Carbon Dioxide and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation

Arterial Carbon Dioxide and Acute Brain Injury in Venoarterial Extracorporeal Membrane Oxygenation

Shou BL, Ong CS, Zhou AL, Al-Kawaz MN, Etchill E et al.

ASAIO J. 2022 Mar 16. Online ahead of print

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 (PaCO2) 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 PaCO2 were defined as the mean of all PaCO2 values in the 12 hours before and after cannulation, respectively. Peri-cannulation PaCO2 drop (ΔPaCO2) equaled pre- minus post-cannulation PaCO2. 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 PaCO2 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) PaCO2 were not different. However, higher pre-cannulation PaCO2 (odds ratio [OR] = 2.10; 95% confidence interval [CI] = 1.10–4.00; p = 0.02) and larger ΔPaCO2 (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 PaCO2 and larger ΔPaCO2 were associated with increased prevalence of ICH.

Leave a Reply

#1 largest online community of Perfusionists

Join Our
Online Community

Get your swag kit by becoming a member or updating profile.
Swag will be sent to U.S. mailing addresses only.

©2023 Perfusion. All Rights Reserved. Privacy Policy