{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:32:26Z","timestamp":1777915946384,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T00:00:00Z","timestamp":1699574400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Perfusion"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intracranial bleeding (ICB) is a serious complication during veno-venous extracorporeal membrane oxygenation (V-V ECMO), with potentially fatal consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the incidence, time of detection of ICB among patients treated with V-V ECMO and potential risk factors for developing ICB during V-V ECMO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five hundred fifty six patients were included in this retrospective single center analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median time on V-V ECMO was 9 (IQR 6-15) days. Intracranial bleeding during V-V ECMO was detected in 10.9% of all patients (61 patients with ICB). Only 17 patients with ICB presented obvious clinical symptoms. Intracranial bleeding was detected on cerebral imaging in median after 5 days (IQR 1-14) after starting V-V ECMO. Overall survival to hospital discharge was 63.7% (ICB: 29.5%). Risk factors of ICB before starting V-V ECMO in univariable analysis were platelets &lt;100\/nl (OR: 3.82), creatinine &gt;1.5mg\/dl (OR: 1.98), norepinephrine &gt;2.5mg\/h (OR: 2.5), ASAT &gt;80U\/L (OR: 1.86), blood-urea &gt;100mg\/dl (OR: 1.81) and LDH &gt;550u\/L (OR: 2.07). Factors associated with cannulation were rapid decrease in paCO\n                      <jats:sub>2<\/jats:sub>\n                      &gt;35mmHg (OR: 2.56) and rapid decrease in norepinephrine &gt;1mg\/h (OR: 2.53). Multivariable analysis revealed low platelets, high paCO\n                      <jats:sub>2<\/jats:sub>\n                      before ECMO, and rapid drop in paCO\n                      <jats:sub>2<\/jats:sub>\n                      after V-V ECMO initiation as significant risk factors for ICB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results emphasize that ICB is a frequent complication during V-V ECMO. Many bleedings were incidental findings, therefore screening for ICB is advisable. The univariate risk factors reflect the underlying disease severity, coagulation disorders and peri-cannulation factors, and may help to identify patients at risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02676591231213514","type":"journal-article","created":{"date-parts":[[2023,11,10]],"date-time":"2023-11-10T17:56:10Z","timestamp":1699638970000},"page":"1667-1675","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Intracranial hemorrhage in a large cohort of patients supported with veno-venous ECMO. A retrospective single-center analysis"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9735-0781","authenticated-orcid":false,"given":"Clemens","family":"Wiest","sequence":"first","affiliation":[{"name":"Clinic and Policlinic of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Lubnow","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Fisser","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alois","family":"Philipp","sequence":"additional","affiliation":[{"name":"Clinic of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9350-3368","authenticated-orcid":false,"given":"Maik","family":"Foltan","sequence":"additional","affiliation":[{"name":"Clinic of Cardiothoracic Surgery, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roland","family":"Schneckenpointner","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maximilian V","family":"Malfertheiner","sequence":"additional","affiliation":[{"name":"Clinic and Policlinic of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany"},{"name":"Clinic of Pneumonology Donaustauf, Donaustauf, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,11,10]]},"reference":[{"issue":"7","key":"bibr1-02676591231213514","first-page":"E166","volume":"7","author":"Makdisi G","year":"2015","journal-title":"J Thorac 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