Artificial organs · 2026
Predictors of Brain Infarction in Pediatric Patients During Extracorporeal Membrane Oxygenation.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Iacobelli Riccardo, Fux Thomas, Wood Schalling Sara, Kopfer Sarah, Berner Jonas, Fletcher-Sandersjöö Alexander, Broman Lars Mikael
Аннотация
INTRODUCTION: Brain infarction (BI) is a severe complication of extracorporeal membrane oxygenation (ECMO) with high morbidity and mortality. We aimed to determine the incidence of BI and identify predictors in pediatric patients receiving ECMO.
METHODS: We performed a retrospective single-center cohort study including patients aged 29 days to < 18 years who underwent ECMO treatment at a tertiary center between January 2010 and October 2023. The primary outcome was BI during ECMO. Predictors of BI were analyzed using logistic regression.
RESULTS: Among 179 included patients, BI was diagnosed in 51 (28%). Multivariable logistic regression identified venoarterial (VA) ECMO (OR 3.82, 95% CI 1.45-10.08; p = 0.007) and higher pre-ECMO arterial lactate (per mmol/L increase, OR 1.11, 95% CI 1.02-1.20; p = 0.01) as independent predictors of BI. The 30-day mortality was 67% among patients with BI compared with 15% among those without BI (p < 0.001).
CONCLUSION: Brain infarction was more common than in most prior reports and was associated with high short-term mortality. VA ECMO mode, compared with venovenous ECMO, and higher pre-ECMO arterial lactate were independent predictors of BI. These findings support enhanced, standardized neurological monitoring and a liberal early brain CT strategy in pediatric ECMO patients, particularly those supported with VA ECMO.
METHODS: We performed a retrospective single-center cohort study including patients aged 29 days to < 18 years who underwent ECMO treatment at a tertiary center between January 2010 and October 2023. The primary outcome was BI during ECMO. Predictors of BI were analyzed using logistic regression.
RESULTS: Among 179 included patients, BI was diagnosed in 51 (28%). Multivariable logistic regression identified venoarterial (VA) ECMO (OR 3.82, 95% CI 1.45-10.08; p = 0.007) and higher pre-ECMO arterial lactate (per mmol/L increase, OR 1.11, 95% CI 1.02-1.20; p = 0.01) as independent predictors of BI. The 30-day mortality was 67% among patients with BI compared with 15% among those without BI (p < 0.001).
CONCLUSION: Brain infarction was more common than in most prior reports and was associated with high short-term mortality. VA ECMO mode, compared with venovenous ECMO, and higher pre-ECMO arterial lactate were independent predictors of BI. These findings support enhanced, standardized neurological monitoring and a liberal early brain CT strategy in pediatric ECMO patients, particularly those supported with VA ECMO.