Factors associated with the development of intracranial hemorrhage in patients treated with extracorporeal membrane oxygenation

David A. Goodwin, Kevin P. Lally, Reese H. Clark, Donald Null

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality during extracorporeal membrane oxygenation (ECMO) and has been associated with prematurity and hypertension. The purpose of this study was to determine whether factors present before the institution of ECMO would predict the development of ICH. Data from the national ECMO registry were collected on all patients who received ECMO over a 2-year period in established centers. Stepwise multivariate analysis was used to determine the relative contribution of different factors in the development of ICH. Data on 972 infants were evaluated; the overall incidence of ICH was 11%. There was a progressive increase in incidence with prematurity, acidosis, and hypercarbia. The best positive predictive value was 60% using all available factors. The premature as well as the term infant with severe metabolic acidosis and hypercarbia has the highest risk to develop ICH on ECMO. Conditions present prior to institution of ECMO therapy have a significant impact on outcome. Although the best predictive ability is only 60%, patients at greatest risk to develop ICH can be identified. Prompt referral and institution of bypass in these patients, when indicated, may modify the subsequent course.

Original languageEnglish (US)
Pages (from-to)229-232
Number of pages4
JournalPediatric Surgery International
Volume10
Issue number4
DOIs
StatePublished - Apr 1 1995
Externally publishedYes

Fingerprint

Extracorporeal Membrane Oxygenation
Intracranial Hemorrhages
Hypercapnia
Acidosis
Incidence
Registries
Referral and Consultation
Multivariate Analysis
Hypertension
Morbidity
Mortality

Keywords

  • ECMO
  • Intracranial hemorrhage
  • Prematurity
  • Sepsis

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Factors associated with the development of intracranial hemorrhage in patients treated with extracorporeal membrane oxygenation. / Goodwin, David A.; Lally, Kevin P.; Clark, Reese H.; Null, Donald.

In: Pediatric Surgery International, Vol. 10, No. 4, 01.04.1995, p. 229-232.

Research output: Contribution to journalArticle

@article{0aee2d9e9dc04c3b863fe60cf444dc22,
title = "Factors associated with the development of intracranial hemorrhage in patients treated with extracorporeal membrane oxygenation",
abstract = "Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality during extracorporeal membrane oxygenation (ECMO) and has been associated with prematurity and hypertension. The purpose of this study was to determine whether factors present before the institution of ECMO would predict the development of ICH. Data from the national ECMO registry were collected on all patients who received ECMO over a 2-year period in established centers. Stepwise multivariate analysis was used to determine the relative contribution of different factors in the development of ICH. Data on 972 infants were evaluated; the overall incidence of ICH was 11{\%}. There was a progressive increase in incidence with prematurity, acidosis, and hypercarbia. The best positive predictive value was 60{\%} using all available factors. The premature as well as the term infant with severe metabolic acidosis and hypercarbia has the highest risk to develop ICH on ECMO. Conditions present prior to institution of ECMO therapy have a significant impact on outcome. Although the best predictive ability is only 60{\%}, patients at greatest risk to develop ICH can be identified. Prompt referral and institution of bypass in these patients, when indicated, may modify the subsequent course.",
keywords = "ECMO, Intracranial hemorrhage, Prematurity, Sepsis",
author = "Goodwin, {David A.} and Lally, {Kevin P.} and Clark, {Reese H.} and Donald Null",
year = "1995",
month = "4",
day = "1",
doi = "10.1007/BF00177166",
language = "English (US)",
volume = "10",
pages = "229--232",
journal = "Pediatric Surgery International",
issn = "0179-0358",
publisher = "Springer Verlag",
number = "4",

}

TY - JOUR

T1 - Factors associated with the development of intracranial hemorrhage in patients treated with extracorporeal membrane oxygenation

AU - Goodwin, David A.

AU - Lally, Kevin P.

AU - Clark, Reese H.

AU - Null, Donald

PY - 1995/4/1

Y1 - 1995/4/1

N2 - Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality during extracorporeal membrane oxygenation (ECMO) and has been associated with prematurity and hypertension. The purpose of this study was to determine whether factors present before the institution of ECMO would predict the development of ICH. Data from the national ECMO registry were collected on all patients who received ECMO over a 2-year period in established centers. Stepwise multivariate analysis was used to determine the relative contribution of different factors in the development of ICH. Data on 972 infants were evaluated; the overall incidence of ICH was 11%. There was a progressive increase in incidence with prematurity, acidosis, and hypercarbia. The best positive predictive value was 60% using all available factors. The premature as well as the term infant with severe metabolic acidosis and hypercarbia has the highest risk to develop ICH on ECMO. Conditions present prior to institution of ECMO therapy have a significant impact on outcome. Although the best predictive ability is only 60%, patients at greatest risk to develop ICH can be identified. Prompt referral and institution of bypass in these patients, when indicated, may modify the subsequent course.

AB - Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality during extracorporeal membrane oxygenation (ECMO) and has been associated with prematurity and hypertension. The purpose of this study was to determine whether factors present before the institution of ECMO would predict the development of ICH. Data from the national ECMO registry were collected on all patients who received ECMO over a 2-year period in established centers. Stepwise multivariate analysis was used to determine the relative contribution of different factors in the development of ICH. Data on 972 infants were evaluated; the overall incidence of ICH was 11%. There was a progressive increase in incidence with prematurity, acidosis, and hypercarbia. The best positive predictive value was 60% using all available factors. The premature as well as the term infant with severe metabolic acidosis and hypercarbia has the highest risk to develop ICH on ECMO. Conditions present prior to institution of ECMO therapy have a significant impact on outcome. Although the best predictive ability is only 60%, patients at greatest risk to develop ICH can be identified. Prompt referral and institution of bypass in these patients, when indicated, may modify the subsequent course.

KW - ECMO

KW - Intracranial hemorrhage

KW - Prematurity

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=0029065135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029065135&partnerID=8YFLogxK

U2 - 10.1007/BF00177166

DO - 10.1007/BF00177166

M3 - Article

VL - 10

SP - 229

EP - 232

JO - Pediatric Surgery International

JF - Pediatric Surgery International

SN - 0179-0358

IS - 4

ER -