61 research outputs found
PCV157 The Impact of Drug Policy on the Utilization of Medicines for Treatment of Cardiovascular Diseases in Slovak Republic
PMD23 Psychometric Analysis And Validation of The Patient Satisfaction With Orthopaedic And Prosthetic Medical Devices, Modul Client Satisfaction With Device (Csd)
Intracranial hemorrhage in a large cohort of patients supported with veno-venous ECMO. A retrospective single-center analysis
Background
Intracranial bleeding (ICB) is a serious complication during veno-venous extracorporeal membrane oxygenation (V-V ECMO), with potentially fatal consequences.
Purpose
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.
Methods
Five hundred fifty six patients were included in this retrospective single center analysis.
Results
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 1.5mg/dl (OR: 1.98), norepinephrine >2.5mg/h (OR: 2.5), ASAT >80U/L (OR: 1.86), blood-urea >100mg/dl (OR: 1.81) and LDH >550u/L (OR: 2.07). Factors associated with cannulation were rapid decrease in paCO2 >35mmHg (OR: 2.56) and rapid decrease in norepinephrine >1mg/h (OR: 2.53). Multivariable analysis revealed low platelets, high paCO2 before ECMO, and rapid drop in paCO2 after V-V ECMO initiation as significant risk factors for ICB.
Conclusion
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
PRS11 THE TREATMENT OF RESPIRATORY DISEASES AND HEALTH CARE BUDGET IMPACT WITHIN SLOVAKIA
Interregional Valuation Of Patient Satisfaction With Pharmaceutical Care As A Tool For Increasing Quality Management In Community Pharmacy And Patients Quality Of Life
Medical Devices For Ostomates. Cost And Quantity Characteristics In Slovakia 2009 - 2013
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