PT  - JOURNAL ARTICLE
AU  - Masur, J.
AU  - Freeman, C.W.
AU  - Mohan, S.
TI  - A Double-Edged Sword: Neurologic Complications and Mortality in Extracorporeal Membrane Oxygenation Therapy for COVID-19–Related Severe Acute Respiratory Distress Syndrome at a Tertiary Care Center
AID  - 10.3174/ajnr.A6728
DP  - 2020 Nov 01
TA  - American Journal of Neuroradiology
PG  - 2009--2011
VI  - 41
IP  - 11
4099  - http://www.ajnr.org/content/41/11/2009.short
4100  - http://www.ajnr.org/content/41/11/2009.full
SO  - Am. J. Neuroradiol.2020 Nov 01; 41
AB  - 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.ARDSAcute Respiratory Distress SyndromeCOVID-19coronavirus disease 2019ECMOextracorporeal membrane oxygenationMERSMiddle East respiratory syndromevvvenovenous