Neurologic Complications During Venoarterial Extracorporeal Membrane Oxygenation and Their Implications for 6-Month Patient-Centered Outcomes

Brown, A; Dennis, M; Rattan, N; Nanjayya, V; Burrell, A; Serpa Neto, A; Hodgson, C; EXCEL (a Comprehensive Binational Registry on the Treatment and Outcomes of Patients Requiring Extracorporeal Membrane Oxygenation [ECMO]) Study Investigators and the International ECMO Network

doi:10.1097/ccm.0000000000006938

Organ support & nutrition

Neurologic Complications During Venoarterial Extracorporeal Membrane Oxygenation and Their Implications for 6-Month Patient-Centered Outcomes

Crit Care MedPublished 10 Nov 2025Prospective observational cohort study

Main finding · Death or new disabilityResultRisk difference 17.28% CI 6.44–25.92%

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Authors' conclusion

Neurologic complications during ECMO increased the risk of death and disability at 6 months, primarily driven by increased death at 6 months.

Study context

Population: Adults admitted to ICU on venoarterial extracorporeal membrane oxygenation (ECMO) other than for ECPR, 30 ECMO centres in Australia and New Zealand, February 2019 to December 2022613 analysed
Participants: 704 adults

Exposure: Neurologic complications vs No neurologic complications
Neurologic complicationsn = 85
Outcome: Composite of:
Death
New disability
Follow-up: 6 months

Methodological detailsmulticentre

Multicentre

Main finding

Death or new disability

Risk difference

17.28%

CI 6.44–25.92%

Neurologic complications vs No neurologic complications

risk difference 17.28% (CI 6.44–25.92%)

As reported in the abstract

Died or new disability at 6 months, all analysed patients: 425 (69.3%)

Observational data: associations, not effects.

Secondary outcomes

Outcome	← Lower with neurologic complications ←→ Higher with neurologic complications →	RD (CI)
Mortality · 6 months	−40−2002040	23.75 (12.06–34.75)
New disability · 6 months	−40−2002040	−11.90% (−30.58% to 13.56%)
	−40−2002040Difference (linear scale)

Outcome	← Lower odds with neurologic complications ←→ Higher odds with neurologic complications →	OR (95% CI)
ECMO discontinued due to perceived poor prognosis	0.050.21520	2.7 (1.35–24.7)
	0.050.21520Odds ratio (log scale)

Original publication

Neurologic Complications During Venoarterial Extracorporeal Membrane Oxygenation and Their Implications for 6-Month Patient-Centered Outcomes. Crit Care Med. Published 10 November 2025. doi:10.1097/ccm.0000000000006938

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