Organ support & nutrition

Prognostic Factors Associated With Intracranial Hemorrhage and Ischemic Stroke During Venovenous Extracorporeal Membrane Oxygenation: A Systematic Review

Crit Care MedPublished Systematic review

Authors' conclusion

This systematic review demonstrates that abnormalities and changes in blood gas parameters from pre- to post-venovenous ECMO cannulation are probably associated with increased risk of ICH.

Study context

Population
Adults undergoing venovenous extracorporeal membrane oxygenation (ECMO)17 studies
Outcome
Prognostic factors for ICH and ischemic stroke during venovenous ECMO
Methodological detailsGRADE certainty assessment, Quality in Prognostic Studies risk of bias
  • GRADE certainty assessment
  • Quality in Prognostic Studies risk of bias

Pooled result

As reported in the abstract

Predictors of ICH and ischemic stroke
  • Lower pH before venovenous ECMO associated with increased intracranial hemorrhage (ICH) risk (5 studies, moderate certainty)
  • Greater decreases in PaCO2 pre- to post-cannulation associated with increased ICH risk (5 studies, moderate certainty)
  • No predictor of ischemic stroke identified in ≥2 studies (4 studies)

Original publication

Prognostic Factors Associated With Intracranial Hemorrhage and Ischemic Stroke During Venovenous Extracorporeal Membrane Oxygenation: A Systematic Review. Crit Care Med. Published 11 December 2024. doi:10.1097/ccm.0000000000006520

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