{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T21:04:41Z","timestamp":1773781481204,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":286,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Critical Care Research and Practice"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Venoarterial extracorporeal membrane oxygenation (VA\u2010ECMO) is a life\u2010saving mechanical support in patients with cardiogenic shock. There are great variations in the reported rates of neurological complications and associated mortality. Our aim was to analyze our cohort of adult patients supported with VA\u2010ECMO to identify the incidence, outcomes, and predictors of acute ischemic and hemorrhagic strokes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 195 patients between January 2016 and January 2023 were reviewed, 22 (11.3%) ECPR patients were excluded, and 173 (88.7%) patients were analyzed. We divided the patients into stroke and nonstroke groups according to the presence of radiologically confirmed acute ischemic and hemorrhagic strokes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010five (20.2%) patients had acute cerebrovascular strokes. 13 (7.5%) patients had intracranial hemorrhage (ICH) while 22 (12.7%) patients had ischemic stroke. The median age was 48\u2009years (IQR: 31, 56), 98 (56.6%) patients were males, and 152 (87.9%) patients had cardiac surgeries. The patients who developed cerebrovascular stroke had higher blood lactate at ECMO initiation (8.9 [5.5, 11.2] versus 5.7 [4.6, 11.9] mmol\/L,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02) and 12\u2009h later (8.7 [4.7, 14.5] versus 5.8 [4.6, 15] mmol\/L,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.024) with lesser lactate clearance (LC) at 12\u2009h (6.35 [\u221251.5, 40.6] versus 14.65% [\u221243.55, 38.3],\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 001) compared to the patients in the nonstroke group. The stroke group had longer ICU stay (21 vs. 15.5\u2009days,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03), higher frequency of new hemodialysis (62.9% vs. 46.4%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.026), and on\u2010ECMO mortality (54.3% vs. 44.9%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.041) compared with the nonstroke group. The ICH was associated with higher hospital mortality (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.021) compared to the ischemic stroke. Logistic multivariate regression revealed that the initial lactate level (OR: 1.6, 95% CI: 1.2\u20138.92,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.031), cardiopulmonary bypass time (OR:1.8, 95% CI: 1.32\u20136.42,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02), and LC at 12\u2009h (OR: 2.4, 95% CI: 1.91\u201317.4,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.042) were associated with ischemic stroke. Thrombocytopenia (OR: 3.22, 95% CI: 1.82\u20137.83,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001) and low body mass index (OR: 2.1, 95% CI: 1.31\u20134.6,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02) were associated with ICH.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ischemic and hemorrhagic strokes are frequent with VA\u2010ECMO support and associated with worse outcomes, especially the hemorrhagic type. Awareness of the incidence and the factors associated with strokes is crucial in early identification and management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ccrp\/9058296","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T06:04:07Z","timestamp":1760508247000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cerebrovascular Strokes During Venoarterial Extracorporeal Membrane Oxygenation"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0752-4574","authenticated-orcid":false,"given":"Zohair","family":"Al-Halees","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9944-012X","authenticated-orcid":false,"given":"Mosleh Nazzal","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6054-9811","authenticated-orcid":false,"given":"Patricia","family":"Machado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9772-4934","authenticated-orcid":false,"given":"Mary Jane","family":"Maghirang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8415-5901","authenticated-orcid":false,"given":"Emad","family":"Hakami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8131-5711","authenticated-orcid":false,"given":"Farouk 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