Kasirajan et al identified risk factors for intracranial hemorrhage in adults receiving extracorporeal membrane oxygenation (ECMO). Attention to risk factors can reduce the risk of this complication, which is associated with increased mortality. The authors are from the Cleveland Clinic.


Risk factors for intracranial hemorrhage:

(1) female gender (odds ratio 7)

(2) heparin therapy (odds ratio 9)

(3) serum creatinine > 2.6 g/dL (odds ratio 7)

(4) need for dialysis (odds ratio 4)

(5) thrombocytopenia, especially when the platelet count is < 50,000 per µL (odds ratio 18)



• A patient on ECMO may show evidence of DIC.


Interventions that can reduce the risk for intracranial hemorrhage:

(1) keeping the platelet count > 100,000 per µL

(2) careful management of anticoagulation

(3) minimizing renal injury


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