{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T22:06:53Z","timestamp":1781734013201,"version":"3.54.5"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T00:00:00Z","timestamp":1628640000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> This study aims to describe the prevalence of neurologic complications and hospital outcome in adult post-cardiotomy cardiogenic shock (PCS) patients receiving veno-arterial extracorporeal membrane oxygenation (V-A ECMO) support and factors associated with such adverse events.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Four hundred and fifteen adult patients underwent cardiac surgery and received V-A ECMO for more than 24 h because of PCS. Patients were divided into two groups: those who developed a neurological complication and those who did not (control group). Multivariable logistic regression was performed to identify factors independently associated with neurologic complications.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Neurologic complications occurred in 87 patients (21.0%), including cerebral infarction in 33 patients (8.0%), brain death in 30 patients (7.2%), seizures in 14 patients (3.4%), and intracranial hemorrhage in 11 (2.7%) patients. In-hospital mortality in patients with neurologic complications was 90.8%, compared to 52.1% in control patients (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). In a multivariable model, the lowest systolic blood pressure (SBP) level pre-ECMO (OR, 0.89; 95% CI: 0.86\u20130.93) and aortic surgery combined with coronary artery bypass grafting (OR, 9.22; 95% CI: 2.10\u201340.55) were associated with overall neurologic complications. Age (OR, 1.06; 95% CI: 1.01\u20131.12) and lowest SBP (OR, 0.81; 95% CI: 0.76\u20130.87) were correlative factors of brain death. Coagulation disorders (OR, 9.75; 95% CI: 1.83\u201351.89) and atrial fibrillation (OR, 12.19; 95% CI: 1.22\u2013121.61) were shown to be associated independently with intracranial hemorrhage, whereas atrial fibrillation (OR, 8.15; 95% CI: 1.31\u201350.62) was also associated with cerebral infarction.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> Neurologic complications in adult PCS patients undergoing V-A ECMO support are frequent and associated with higher in-hospital mortality. Identified risk factors of neurologic complications might help to improve ECMO management and might reduce their occurrence.<\/jats:p>","DOI":"10.3389\/fmed.2021.721774","type":"journal-article","created":{"date-parts":[[2021,8,11]],"date-time":"2021-08-11T07:29:17Z","timestamp":1628666957000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Neurologic Complications in Adult Post-cardiotomy Cardiogenic Shock Patients Receiving Venoarterial Extracorporeal Membrane Oxygenation: A Cohort 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