Journal of Intensive Care Medicine最新文献

{"title":"Palliative Care Outcomes for Critically ill Children After Rapid Whole Genome Sequencing.","authors":"Katherine Perofsky, Ami Doshi, Zaineb Boulil, Julia Beauchamp Walters, Euyhyun Lee, David Dimmock, Stephen Kingsmore, Nicole G Coufal","doi":"10.1177/08850666241304320","DOIUrl":"https://doi.org/10.1177/08850666241304320","url":null,"abstract":"<p><strong>Objectives: </strong>Clinical utility of rapid whole genome sequencing (rWGS) has been reported in 30-70% of pediatric ICU patients who receive a molecular diagnosis. Rapid molecular diagnostic techniques have been increasingly integrated into critical care, yet the influence of genetic test results on palliative care related decision making is largely unknown. This study evaluates palliative care related outcomes after rWGS.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary children's hospital.</p><p><strong>Patients: </strong>Acutely ill children <math><mo>≤</mo></math> 18 years of age who received rWGS due to suspected genetic disease between July 2016 and November 2019.</p><p><strong>Interventions: </strong>rWGS with associated precision medicine.</p><p><strong>Measurements and main results: </strong>536 patients underwent rWGS, of whom 152 (28.4%) received a molecular diagnosis. Diagnostic rWGS was associated with more code status modifications, an increase in palliative care inpatient consultations, and greater enrollment in home-based palliative services. A comparison of diagnostic and nondiagnostic rWGS groups where palliative decisions were made prior to reporting of genomic testing results did not identify differences between the groups. In the subset of patients who had palliative care interventions (<i>n </i>= 57, 53% with diagnostic rWGS), time to palliative care consultation and time to compassionate extubation were shorter for patients with rWGS-based diagnoses (Kaplan-Meier method, <i>P </i>= .008; <i>P </i>= .015). Significantly more patients in this subgroup with diagnostic rWGS received home-based palliative care (Chi-squared, <i>P = </i>.025, 95% CI [-0.47, -0.05]). Univariate Poisson regression indicated that diagnostic rWGS is associated with significantly fewer emergency visits, PICU admissions, and unplanned intubations.</p><p><strong>Conclusions: </strong>Diagnostic rWGS correlates with more rapid engagement of pediatric palliative care services, higher enrollment rates in home-based palliative care, and shorter time to compassionate extubation. Further studies are needed with larger cohort sizes and validated pediatric palliative care outcome measurement tools to accurately determine if this change in care is driven by the underlying condition or knowledge of a molecular diagnosis.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241304320"},"PeriodicalIF":3.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Valproic Acid for Hyperactive Delirium and Agitation in Critically Ill Patients.","authors":"Olivia Nuti, Cristian Merchan, Tania Ahuja, Serena Arnouk, John Papadopoulos, Alyson Katz","doi":"10.1177/08850666241302760","DOIUrl":"https://doi.org/10.1177/08850666241302760","url":null,"abstract":"<p><strong>Background: </strong>Delirium and agitation are common syndromes in critically ill patients. Valproic acid (VPA) has shown benefit in intensive care unit (ICU)-associated delirium and agitation, but further evaluation is needed.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate the effectiveness and safety of VPA for hyperactive delirium and agitation in critically ill adult patients.</p><p><strong>Methods: </strong>A retrospective cohort study at NYU Langone Health was conducted in critically ill patients treated with VPA for hyperactive delirium or agitation from October 1, 2017 to October 1, 2022. The primary outcome was effectiveness of VPA, defined as a reduction in the total number of any concomitant psychoactive medication by day 3 of VPA treatment. Secondary outcomes included the effect of VPA on the doses of concomitant medications and adverse events.</p><p><strong>Results: </strong>A total of 87 patients were included in the final analysis. By day 3 of VPA treatment, a 33% reduction (<i>P</i> < .001) in the total number of concomitant psychoactive medications was observed. VPA decreased the need for sedatives, as assessed by midazolam equivalents, but no significant changes were seen with dexmedetomidine alone, opioids, or antipsychotics. A 10 mg/kg loading dose was utilized in 36% of the cohort and its use decreased the risk for initiating additional psychoactive medications by day 3 of therapy (OR 2.8, 95% CI 1.0-7.8, <i>P</i> = .047), with benefits noted as early as 48 h after initiation. Adverse events were low in the total cohort (10.3%).</p><p><strong>Conclusion and relevance: </strong>The addition of VPA to a complex pharmacologic regimen for hyperactive delirium and agitation is safe and can assist in the prevention of polypharmacy and overall workload in critically ill patients admitted primarily for cardiogenic shock and respiratory failure requiring mechanical ventilation.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241302760"},"PeriodicalIF":3.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiooncology in the ICU - Cardiac Urgencies in Cancer Care.","authors":"Stephanie Wu, Faizi Jamal","doi":"10.1177/08850666241303461","DOIUrl":"https://doi.org/10.1177/08850666241303461","url":null,"abstract":"<p><p>Cardiovascular disease is an increasing risk of morbidity and mortality in cancer patients, related to an growing number of aging survivors with pre-existing cardiovascular disease and the use of traditional and novel cancer therapies with cardiotoxic effects. While many cardiac complications are chronic processes that develop over time, there are many acute processes that may arise in hospitalized patients. It is important for hospitalists and critical care physicians to be familiar with the recognition and management of these conditions in this unique population. This article reviews the presentation and management of common cardiac urgencies in critically ill cancer patients including acute decompensated heart failure, acute coronary syndromes, arrhythmias, hypertensive crises, pulmonary embolism, pericardial tamponade and myocarditis.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241303461"},"PeriodicalIF":3.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Factors of Hospital Mortality After Near Hanging: A Retrospective two-Center French Study.","authors":"Yanis Gueddoum, Antoine Goury, Vincent Legros, Thierry Floch, Bruno Mourvillier, Guillaume Thery","doi":"10.1177/08850666241303881","DOIUrl":"https://doi.org/10.1177/08850666241303881","url":null,"abstract":"<p><strong>Introduction: </strong>suicide is a global public health issue, with over 800 000 people taking their own lives every year. However, most suicide attempts do not result in death. Hanging is the most common method used in France, often leading to post-hanging coma (PHC). The prognosis for patients admitted in intensive care unit (ICU) following PHC is poor, yet predictive criteria of mortality have been poorly evaluated.</p><p><strong>Methods: </strong>we retrospectively collected prehospital and in-hospital data from 65 patients hospitalized in 2 French ICU for PHC, between first March 2010 and first August 2023, and compared characteristics between patients alive and dead.</p><p><strong>Results: </strong>hospital mortality was 52%. Among baseline characteristics, SAPSII and pre-hospital cardiac arrest were associated with mortality, respectively 47 versus 62 (<i>P</i> = .005) and 32% versus 85% (<i>P</i> = .001). Concerning neuroprognostication, abnormal pupillary light reflex (PLR) was more frequent in patients who died (14% vs 56%, <i>P</i> = .002), as abnormal EEG (0% vs 32%, <i>P</i> = .002) and abnormal transcranial doppler (10% vs 35%, <i>P</i> = .031).</p><p><strong>Conclusion: </strong>we identified several poor prognostic factors associated with hospital mortality after PHC. Further larger-scale studies are needed to supplement these findings.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241303881"},"PeriodicalIF":3.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Chest Compression Pauses During Pediatric ECPR.","authors":"Elena M Insley, Andrew S Geneslaw, Tarif A Choudhury, Anita I Sen","doi":"10.1177/08850666241301023","DOIUrl":"https://doi.org/10.1177/08850666241301023","url":null,"abstract":"<p><p><b>Objective:</b> To quantify chest compression (CC) pauses during pediatric ECPR (CPR incorporating ECMO) and implement sustainable quality improvement (QI) initiatives to reduce CC pauses during ECMO cannulation. <b>Methods:</b> We retrospectively identified baseline CC pause characteristics during pediatric ECPR events (pre-intervention), deployed QI interventions to reduce CC pause length, and then prospectively quantified CC pause metrics post-QI interventions (post-intervention). Data were gathered from a single center review of CC-pause characteristics in children less than 18 years old with a PICU ECPR arrest. QI Interventions included: (1) sharing baseline CC data with ECPR stakeholders, (2) establishing consensus among providers regarding areas for improvement, and (3) creating a communication aid to encourage counting CC pauses out loud. Multidisciplinary ECPR simulations allowed for practice of these skills. Using telemetry data, CC pause metrics were analyzed in the medical (CPR before cannulation) and surgical (CPR during ECMO cannulation, demarcated by the sterile draping of the patient) phases of ECPR, pre- and post-intervention. <b>Results:</b> Pre-intervention, 11 ECPR events (5 central cannulation, 6 peripheral cannulation) met inclusion criteria compared with 14 ECPR events (2 central, 12 peripheral) post-intervention. Pre-intervention analysis identified longer CC pauses and lower chest compression fraction (CCF) during the surgical versus medical phase of ECPR. Compared to pre-intervention data, CCF during the surgical phase of ECPR improved from 66% to 81% (73-85%) post-intervention (<i>P</i> = .02). Median CC pause length was significantly reduced from 20 s pre-intervention to 10.5 (9-13) seconds post-intervention (<i>P</i> = .01). There was no change in the surgical phase of ECPR duration (44 min pre- vs 41 min post-intervention, <i>P</i> = .8) or survival to hospital discharge (45% vs 21%, <i>P</i> = .4). <b>Conclusion:</b> Simple and feasible communication interventions during ECPR can minimize CC pauses, increase CCF and improve CPR quality without prolonging the time needed for ECMO cannulation.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"8850666241301023"},"PeriodicalIF":3.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Gram Stain-Guided Antibiotic Therapy for Methicillin-Resistant <i>Staphylococcus aureus</i> Pneumonia in Intensive Care Unit Patients.","authors":"Johanna Van Epps, Alexander J Lepak, Lucas T Schulz, Jeffrey Fish","doi":"10.1177/08850666241254736","DOIUrl":"10.1177/08850666241254736","url":null,"abstract":"<p><p><b>Background:</b> Despite high negative predictive values (NPVs) seen with methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) nares polymerase chain reaction (PCR) assays, utilization of both respiratory sample Gram stain and MRSA nares PCR in patients with pneumonia may contribute to overuse of laboratory resources. The purpose of this study was to evaluate if a Gram stain demonstrating no Gram-positive organisms from a respiratory sample is sufficient to allow for de-escalation of vancomycin therapy. <b>Methods:</b> This single center study retrospectively identified intensive care unit (ICU) patients started on vancomycin for presumed pneumonia at University of Wisconsin (UW) Health in Madison, WI between August 2022 and March 2023. Patients with respiratory sample demonstrating no Gram-positives on Gram stain met inclusion criteria if the sample was ordered within 24 h of vancomycin initiation. The primary outcome was NPV of respiratory sample Gram stain demonstrating no Gram-positive organisms with respect to MRSA detection of the respiratory culture. Secondary outcomes included the NPV of combined MRSA nares PCR plus respiratory sample Gram stain, and difference in time to event in patients that had both a respiratory sample and MRSA nares PCR ordered. <b>Results:</b> A total of 370 patients were screened for study eligibility; of which 99 patients met inclusion criteria. NPV of respiratory sample Gram stain was 99% for MRSA culture. The combined NPV of respiratory sample Gram stain plus MRSA nares PCR was 98.9% for MRSA culture (n = 88). Respiratory sample was ordered 2.3 h faster compared to MRSA nares PCR (4.3 vs 6.6 h, <i>P</i> = .036). Respiratory sample Gram stain resulted 4.5 h faster compared to MRSA nares PCR (10.7 vs 15.2 h, <i>P</i> = .002). <b>Conclusion:</b> Respiratory sample Gram stains demonstrating no Gram-positive organisms may be used to de-escalate vancomycin and deprioritize the use of MRSA nares PCR.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1231-1237"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Helmet c-PAP Versus NIPPV in Association with Early Respiratory Physiotherapy and Mobilization for Treating SARS-CoV-2 ARDS: A Case-control Prospective Single-center Study.","authors":"Alberto Corona, Giuseppe Richini, Alice Capone, Elena Zendra, Ivan Gatti, Clemente Santorsola, Sara Simoncini, Mauro Pasqua, Monica Biasini, Miryam Shuman","doi":"10.1177/08850666241256887","DOIUrl":"10.1177/08850666241256887","url":null,"abstract":"<p><p><b>Introduction:</b> Early noninvasive respiratory support (NIRS) is correlated with a success rate of 60-75% in patients experiencing SARS-CoV-2 ARDS. We conducted a prospective case-control study to assess differences in outcomes between Helmet c-PAP (H-c-PAP) and noninvasive positive pressure ventilation (NIPPV). <b>Methods:</b> All patients with SARS-CoV-2 ARDS, treated with H-c-PAP or NIPPV between October 2021 and April 2022 were sampled. We recorded: demographics, comorbidities, clinical, respiratory, sepsis, NIRS parameters, and outcomes. A \"NIRS team\" followed the patients in respiratory support supplying them with early and timely intensive physiotherapy i-PKT as well. The Cox's proportional hazard model was applied for multivariate analyses. <b>Results:</b> 368 patients were admitted to our hospital medical ward. 85 patients were treated with H-c-PAP and 145 underwent NIPPV. 138 patients needing oxygen supplementation alone were excluded. The two groups were homogeneously distributed and ICU admission rates were lower in the H-c-PAP one (9.4 vs 11% <i>P</i> = .001) while mortality was higher in the NIPPV group (22.7 vs 9.4%, <i>P</i> = .001). The two multivariate models, that had overall mortality as primary outcome, identified age, H-c-PAP daily, i-PKT and ICU admission as independent variables impacting on the outcome. Age was no longer a significant independent predictor after the inclusion of elderly patients (age >80). The third model showed daily i-PKT could prevent ICU admission whereas the length of NIRS was inversely proportional to outcome. <b>Conclusions:</b> A \"NIRS multidisciplinary team\" made it possible to adopt an early and timely combination of NIRS and i-PKT resulting in the saving of both patient lives and ICU resources.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1256-1265"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141283888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tight Versus Liberal Blood Glucose Control in Patients With Diabetes in the ICU: A Meta-Analysis of Randomized Controlled Trials.","authors":"Maria L R Defante, Beatriz Ximenes Mendes, Mariana de Moura de Souza, Beatriz Austregésilo de Athayde De Hollanda Morais, Otávio Cosendey Martins, Vitória Martins Prizão, Salma Ali El Chab Parolin","doi":"10.1177/08850666241255671","DOIUrl":"10.1177/08850666241255671","url":null,"abstract":"<p><p><b>Introduction:</b> Glycemia is an important factor among critically ill patients in the intensive care unit (ICU). There is conflicting evidence on the preferred strategy of blood glucose control among patients with diabetes in the ICU. We aimed to conduct a meta-analysis comparing tight with liberal blood glucose in critically ill patients with diabetes in the ICU. <b>Methods:</b> We systematically searched PubMed, Embase, and Cochrane Central for randomized controlled trials (RCTs) comparing tight versus liberal blood glucose control in critically ill patients with diabetes from inception to December 2023. We pooled odds-ratios (OR) and 95% confidence intervals (CI) with a random-effects model for binary endpoints. We used the Review Manager 5.17 and R version 4.3.2 for statistical analyses. Risk of bias assessment was performed with the Cochrane tool for randomized trials (RoB2). <b>Results:</b> Eight RCTs with 4474 patients were included. There was no statistically significant difference in all-cause mortality (OR 1.11; 95% CI 0.95-1.28; <i>P</i> = .18; I² = 0%) between a tight and liberal blood glucose control. RoB2 identified all studies at low risk of bias and funnel plot suggested no evidence of publication bias. <b>Conclusion:</b> In patients with diabetes in the ICU, there was no statistically significant difference in all-cause mortality between a tight and liberal blood glucose control. PROSPERO registration: CRD42023485032.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1250-1255"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140945207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurally Adjusted Ventilatory Assist Versus Pressure Support Ventilation: A Comprehensive Review.","authors":"Saikiran Mandyam, Muhammad Qureshi, Yamini Katamreddy, Devam Parghi, Priyanka Patel, Vidhi Patel, Fnu Anshul","doi":"10.1177/08850666231212807","DOIUrl":"10.1177/08850666231212807","url":null,"abstract":"<p><p>Mechanical ventilation serves as crucial life support for critically ill patients. Although it is life-saving prolonged ventilation carries risks and complications like barotrauma, Ventilator-associated pneumonia, sepsis, and many others. Optimizing patient-ventilator interactions and facilitating early weaning is necessary for improved intensive care unit (ICU) outcomes. Traditionally Pressure support ventilation (PSV) mode is widely used for weaning patients who are intubated and mechanically ventilated. Neurally adjusted ventilatory assist (NAVA) mode of the ventilator is an emerging ventilator mode that delivers pressure depending on the patient's respiratory drive, which in turn prevents over-inflation and improves the patient's ventilator interactions. Our article revises and compares the effectiveness of NAVA compared to PSV ventilation under different contexts. Overall we conclude that NAVA level of ventilation can be safely administered in a patient with acute respiratory failure, provided diaphragmatic paralysis is not considered. NAVA improves asynchrony index, wean-off time, and sleep quality and is associated with increased ventilator-free days. These results are based on small-scale studies with low power, and further studies are warranted in large-scale cohorts with more diverse populations to confirm these results.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1194-1203"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107591493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal Cord Infarction During Extracorporeal Membrane Oxygenation：A Case Series and Review of the Literature.","authors":"Hui Meng, Fang He, Xianrang Yan, Lanchun Chen, Xiaohong Lin, Xiaolong She, Xuetao Yu","doi":"10.1177/08850666241272067","DOIUrl":"10.1177/08850666241272067","url":null,"abstract":"<p><p><b>Background:</b> Little is known about extracorporeal membrane oxygenation (ECMO)-related spinal cord infarction (SCI), and reports regarding this rare and catastrophic complication are rare. Here, we report two cases of ECMO-related SCI that occurred between April and December 2023. Data were collected from patients' medical records, with SCI as the endpoint. We reviewed previously published reports by searching PubMed and summarizing the findings. <b>Case summary:</b> One female patient presenting with multiple traumas required oxygenation support through veno-venous ECMO (VV ECMO) due to pulmonary hemorrhage, while one male patient required circulatory support via veno-arterial ECMO (VA ECMO) concurrently with an intra-aortic balloon pump due to cardiac arrest. Neither patient had preexisting neurological deficits; however, upon weaning from ECMO, they presented with severe neurological deficits of uncertain etiology, subsequently confirmed as SCI using magnetic resonance imaging. <b>Conclusion:</b> ECMO-related SCI remains elusive and intricate, and this is the first report of adult VV ECMO-related SCI.</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":" ","pages":"1274-1281"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}