초록접수 현황
| 20F-207 | 포스터 발표 |
Stroke in Extracorporeal Membrane Oxygenation: Risk Factors and Clinical Outcomes
Harim Kim, M.D., Yang Hyun Cho, M.D.
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center
Purpose : Among various complications of extracorporeal membrane oxygenation, stroke continues to threaten clinical outcome as it is related with mortality, and adverse neurologic performance. This study analyzes stroke related risk factors and outcomes, to suggest appropriate intervention to minimize neurologic sequalae while on ECMO.
Methods : A total of 1039 patients who underwent ECMO from January 2012 to September 2019 in Samsung Medical Center were reviewed. Primary outcome was set as stroke during ECMO support. Stroke was defined as acute neurologic dysfunction caused by hypoxic, ischemic, or hemorrhagic episode of the brain. Exclusion criteria were age under 18, failure of ECMO insertion, multiple ECMO runs, underlying brain injury, and incomplete medical record for the study.
Results : Out of 1039, 759 were selected for analysis. Among them, 570(75.1%) underwent venoarterial(VA) ECMO and 193(24.5%) received venovenous(VV) ECMO insertion. Overall incidence of stroke was 5.1%(n=39) without significant difference between VA and VV ECMO(5.3% and 4.8%, p=0.480). Risk factors for stroke were intraaortic balloon pump(IABP)(p=0.0008) and history of stroke(p=0.0354). 80% of stroke occurred within 8 days of VA ECMO insertion, and 50% within 3 days of VV ECMO insertion. Time taken for stroke event from ECMO insertion was shorter for VA ECMO(p=0.024). Overall mortality of ECMO in our institution was 45.7%(n=347) and stroke group showed higher mortality rate compared with non-stroke group(64.1% and 44.7%, p=0.014).
Conclusion : Concurrent ECMO and IABP use may contribute to higher incidence of stroke. Also, routine CT to screen stroke in ECMO may lead to better neurologic outcome, allowing timely intervention.
Methods : A total of 1039 patients who underwent ECMO from January 2012 to September 2019 in Samsung Medical Center were reviewed. Primary outcome was set as stroke during ECMO support. Stroke was defined as acute neurologic dysfunction caused by hypoxic, ischemic, or hemorrhagic episode of the brain. Exclusion criteria were age under 18, failure of ECMO insertion, multiple ECMO runs, underlying brain injury, and incomplete medical record for the study.
Results : Out of 1039, 759 were selected for analysis. Among them, 570(75.1%) underwent venoarterial(VA) ECMO and 193(24.5%) received venovenous(VV) ECMO insertion. Overall incidence of stroke was 5.1%(n=39) without significant difference between VA and VV ECMO(5.3% and 4.8%, p=0.480). Risk factors for stroke were intraaortic balloon pump(IABP)(p=0.0008) and history of stroke(p=0.0354). 80% of stroke occurred within 8 days of VA ECMO insertion, and 50% within 3 days of VV ECMO insertion. Time taken for stroke event from ECMO insertion was shorter for VA ECMO(p=0.024). Overall mortality of ECMO in our institution was 45.7%(n=347) and stroke group showed higher mortality rate compared with non-stroke group(64.1% and 44.7%, p=0.014).
Conclusion : Concurrent ECMO and IABP use may contribute to higher incidence of stroke. Also, routine CT to screen stroke in ECMO may lead to better neurologic outcome, allowing timely intervention.
첨부파일 : 대한흉부심장혈관외과학회 Figure 김하림.docx
책임저자: Yang Hyun Cho
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center
발표자: 김하림, E-mail : k3541729@gmail.com