Intracranial haemorrhage and neurological complications in ECMO

• Research type

  Research Study

• Full title

  Retrospective cohort study of intracranial haemorrhage (ICH) and neurological complications in ECMO patients

• IRAS ID

  224190

• Contact name

  Deepa Jayakody Arachchillage

• Contact email

  d.arachchillage@rbht.nhs.uk

• Sponsor organisation

  Royal Brompton & Harefield NHS Foundation Trust

• Duration of Study in the UK

  0 years, 3 months, 1 days

• Research summary

  Extracorporeal membrane oxygenation (ECMO) is increasingly used to provide cardiopulmonary support to patients with severe refractory cardiac and respiratory failure. Despite increasing experience with ECMO and recent technical improvements, the morbidity and mortality of patients receiving ECMO remains high, but varies significantly between centres, patient subgroups and by indication.
  Intracranial Haemorrhage (ICH) is a common and serious complication in patients supported with ECMO with a reported incidence ranging from 5% to 19% and predominantly fatal outcome. It is unclear whether ICH is a consequence of ECMO itself or of the underlying disease process. Previous studies addressing this issue have not screened patients for neurological damage including ICH at the time of initiating ECMO to rule out existing bleeding events in critically ill patients, therefore it is possible that these complications occurred prior to initiation of ECMO. It is our standard practice to perform a CT head in all ECMO patients on admission and those who develop new neurological symptoms/signs have repeat CT imaging; this allows differentiation between ICH at initiation and during ECMO treatment.
  This study aims to determine: 1) the incidence of ICH or other neurological complications in patients receiving ECMO, 2) the associated mortality of these complications and 3) any predictive markers of developing ICH or other neurological complication in patients receiving ECMO.
  The study will be a retrospective cohort study looking at all patients who received ECMO treatment at the Royal Brompton ITU from June 2011 to December 2016 who suffered ICH and other neurological complications. Clinical notes will be reviewed and data collected on a number of factors including demographics, type and severity of illness, haematological blood markers and CT scan reports. Based on this data a prospective study will be designed to attempt to determine successful interventions which can reduce the risk of ICH and other brain injury in this patient group

• REC name

  London - Central Research Ethics Committee

• REC reference

  17/LO/0808

• Date of REC Opinion

  4 May 2017

• REC opinion

  Favourable Opinion