Longtime Neurologic Outcome of Extracorporeal Membrane Oxygenation and Non Extracorporeal Membrane Oxygenation Acute Respiratory Distress Syndrome Survivors

Abstract

Neurologic complications following acute respiratory distress syndrome (ARDS) are well described, however, information on the neurologic outcome regarding peripheral nervous system complications in critically ill ARDS patients, especially those who received extracorporeal membrane oxygenation (ECMO) are lacking. In this prospective observational study 28 ARDS patients who survived after ECMO or conventional nonECMO treatment were examined for neurological findings. Nine patients had findings related to cranial nerve innervation, which differed between ECMO and nonECMO patients (p = 0.031). ECMO patients had severely increased patella tendon reflex (PTR) reflex levels (p = 0.027 vs. p = 0.125) as well as gastrocnemius tendon reflex (GTR) (p = 0.041 right, p = 0.149 left) were affected on the right, but not on the left side presumably associated with ECMO cannulation. Paresis (14.3% of patients) was only found in the ECMO group (p = 0.067). Paresthesia was frequent (nonECMO 53.8%, ECMO 62.5%; p = 0.064), in nonECMO most frequently due to initial trauma and polyneuropathy, in the ECMO group mainly due to impairments of N. cutaneus femoris lateralis (4 vs. 0; p = 0.031). Besides well-known central neurologic complications, more subtle complications were detected by thorough clinical examination. These findings are sufficient to hamper activities of daily living and impair quality of life and psychological health and are presumably directly related to ECMO therapy.

Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain

“…As a human respiratory coronavirus, SARS-CoV-2 infection causes inflammatory damage to most type II alveolar cells, which may be aggravated by ventilatorinduced lung injury following mechanical ventilation or extracorporeal membrane oxygenation treatment [1,10,11]. Furthermore, damage to the liver, heart, and kidney has been reported [12,13].…”

Blood neurofilament light chain and total tau levels at admission predict death in COVID-19 patients

“…Direct invasion of the central nervous system (CNS) by SARS-CoV-2 is a controversial issue, with contradictory findings generating a lively debate in current literature [ 1 – 4 ]. Acute respiratory distress syndrome (ARDS), however, is associated to nervous system damage and neurological sequelae also in the absence of a clinically apparent CNS infection [ 5 , 6 ]. The Coronavirus disease 2019 (COVID-19) is no exception, and neurological and psychiatric consequences of the disease have been described in large patients series [ 7 , 8 ] and are associated to MRI and EEG changes [ 7 , 8 ].…”

Successful resuscitation by using extracorporeal membrane oxygenation in a patient with amniotic fluid embolism: a case report

“…23 The most commonly known complication is sensory deficits in the right lateral cutaneous nerve of the thigh. 24 This may be relevant to our patient because she was cannulated through the right femoral vein.…”