Extracorporeal membrane oxygenation (ECMO) is potentially lifesaving for patients with acute respiratory distress syndrome (ARDS) but may be accompanied by serious adverse events, including intracranial hemorrhage (ICRH). We hypothesized that ICRH occurs more frequently in patients with COVID-19 than in patients with ARDS of other etiologies. We performed a single-center retrospective analysis of adult patients treated with venovenous (vv-) ECMO for ARDS between January 2011 and April 2021. Patients were included if they had received a cranial computed tomography (cCT) scan during vv-ECMO support or within 72 h after ECMO removal. Cox regression analysis was used to identify factors associated with ICRH. During the study period, we identified 204 patients with vv-ECMO for ARDS, for whom a cCT scan was available. We observed ICRH in 35.4% ( n = 17/48) of patients with COVID-19 and in 16.7% ( n = 26/156) of patients with ARDS attributable to factors other than COVID-19. COVID-19 (HR: 2.945; 95%; CI: 1.079–8.038; p = 0.035) and carboxyhemoglobin (HR: 0.330; 95%; CI: 0.135–0.806; p = 0.015) were associated with ICRH during vv-ECMO. In patients receiving vv-ECMO, the incidence of ICRH is doubled in patients with COVID-19 compared to patients suffering from ARDS attributable to other causes. More studies on the association between COVID-19 and ICRH during vv-ECMO are urgently needed to identify risk patterns and targets for potential therapeutic interventions.
【저자키워드】 COVID-19, acute respiratory distress syndrome, extracorporeal membrane oxygenation, Neurologic complications, Intracerebral hemorrhage, Hemorrhagic Stroke, 【초록키워드】 ARDS, risk, Computed tomography, Patient, Retrospective analysis, ECMO, membrane, target, incidence, association, acute respiratory distress, hemorrhage, Extracorporeal, Oxygenation, Support, Serious Adverse Events, Factor, causes, study period, Cox regression analysis, syndrome, single-center, therapeutic interventions, etiologies, identify, performed, was used, receiving, occur, accompanied, cranial, patients treated, patients with ARDS, patients with COVID-19, 【제목키워드】 respiratory, Intracranial, Extracorporeal,