Stroke is a complication of extracorporeal membrane oxygenation (ECMO) therapy. It increases the risk of morbidity and mortality of the procedure. The authors are from multiple institutions participating in the Extracorporeal Life Support Organization Registry.
Patient selection: ECMO, venovenous or venoarterial
Outcome: stroke, ischemic or hemorrhagic
Risk factors for ischemic stroke while receiving venovenous ECMO:
(1) pre-ECMO arterial pH (aOR 0.10)
(2) hemolysis (aOR2.3)
(3) gastrointestinal hemorrhage (aOR2.0)
(4) DIC (aOR3.6)
Risk factors for hemorrhagic stroke while receiving venovenous ECMO:
(1) pre-ECMO pH (aOR 0.28)
(2) pre-ECMO PaO2(aOR 0.96)
(3) gastrointestinal hemorrhage(aOR1.7)
(4) renal replacement therapy (aOR1.6)
Risk factors for ischemic stroke while receiving venoarterial ECMO:
(1) pre-ECMO arterial pH (aOR 0.21)
(2) higher PaO2 on first day of ECMO (aOR1.01)
(3) higher rate of circuit mechanical failure (aOR1.3)
(4) renal replacement therapy (RRT)(aOR1.5)
Risk factors for hemorrhagic stroke while receiving venoarterial ECMO:
(1) female sex (aOR1.6)
(2) longer duration of ECMO (aOR1.01)
(3) renal replacement therapy (RRT)(aOR1.8)
(4) hemolysis (aOR1.9)
