Clinical Outcomes of Extracorporeal Membrane Oxygenation Use in Patients With Intracranial Hemorrhage.

Abstract

Background: Patients undergoing extracorporeal membrane oxygenation are at a high risk of developing intracranial hemorrhage as a neurological complication. Consequently, many physicians consider a history of intracranial hemorrhage as a relative contraindication for extracorporeal membrane oxygenation and are hesitant to use it in these patients, even in cases of acute severe heart or lung failure. This study aimed to examine the clinical outcomes of extracorporeal membrane oxygenation use in patients with intracranial hemorrhage.

Methods: We retrospectively obtained the medical records of patients diagnosed with intracranial hemorrhage who received extracorporeal membrane oxygenation owing to acute cardiopulmonary failure between January 2011 and July 2020. Data pertaining to patients' characteristics and clinical outcomes were collected. Disseminated intravascular coagulation score and extracorporeal membrane oxygenation score before and after application of extracorporeal membrane oxygenation were also examined to observe trends.

Results: Eighteen patients were included. Ten had traumatic intracranial hemorrhage, and the most common indication for extracorporeal membrane oxygenation was acute respiratory distress syndrome. The 30-day survival rate was 72% (13 patients), and 61% (11 patients) survived to discharge. Two patients underwent neurosurgery due to worsening of intracranial hemorrhage. However, both were discharged without neurological deterioration.

Conclusion: A 72% survival rate was observed in extracorporeal membrane oxygenation patients with intracranial hemorrhage, suggesting that extracorporeal membrane oxygenation could be a viable option in patients with intracranial hemorrhage unresponsive to conventional therapy.