Abstract
SUMMARY: In this clinical case series, we report our experience to date with neurologic complications of extracorporeal membrane oxygenation therapy for COVID-19 Acute Respiratory Distress Syndrome. We have found an unexpectedly increased rate of complications as demonstrated by neuroimaging compared with meta-analysis data in extracorporeal membrane oxygenation therapy for all Acute Respiratory Distress Syndrome etiologies over the past few decades and compared with the most recent baseline data describing the incidence of neurologic complication in all patients with COVID-19. For our 12-patient cohort, there was a rate of intracranial hemorrhage of 41.7%. Representative cases and images of devastating intracranial hemorrhage are presented. We hypothesize that the interplay between hematologic changes inherent to extracorporeal membrane oxygenation and inflammatory and coagulopathic changes that have begun to be elucidated as part of the COVID-19 disease process are responsible. Continued analysis of extracorporeal membrane oxygenation therapy in this disease paradigm is warranted.
ABBREVIATIONS:
- ARDS
- Acute Respiratory Distress Syndrome
- COVID-19
- coronavirus disease 2019
- ECMO
- extracorporeal membrane oxygenation
- MERS
- Middle East respiratory syndrome
- vv
- venovenous
Footnotes
Disclosures: Colbey Freeman—UNRELATED: Grants/Grants Pending: RSNA, NVIDIA, Comments: RSNA resident grant 2020-2021 to institution, NVIDIA GPU grant 2019 provided to me.* Suyash Mohan—UNRELATED: Consultancy: Northwest Biotherapeutics; Grants/Grants Pending: Novocure, Galileo.* *Money paid to the institution.
- © 2020 by American Journal of Neuroradiology
Indicates open access to non-subscribers at www.ajnr.org