Evidence map›Paper›PMID 32424429›Full record

ArticleNeurosurgery2020

Neurologically Devastating Intraparenchymal Hemorrhage in COVID-19 Patients on Extracorporeal Membrane Oxygenation: A Case Series.

Sabrina M Heman-Ackah, YouRong Sophie Su, Michael Spadola, Dmitriy Petrov, H Isaac Chen, James Schuster, Timothy Lucas

Open access · greenAbstract readCase Reports
In one paragraph

Article in Neurosurgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 5 pooled it
3.6field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 41 citations in OpenAlex.

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  5. Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021
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  18. Severe Neurologic Complications of SARS-CoV-2.Current treatment options in neurology · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Sabrina M Heman-AckahDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
YouRong Sophie SuDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Michael SpadolaDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Dmitriy PetrovDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
H Isaac ChenDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
James SchusterDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
Timothy LucasDepartment of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania.
University of Pennsylvania · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and importanceExtracorporeal membrane oxygenation (ECMO) represents a life-saving therapy in cases of refractory hypoxia and has been utilized in patients suffering from the most severe forms of coronavirus disease 2019 (COVID-19). A strikingly high mortality rate of 94% was described in early reports of patients with COVID-19 transitioned to ECMO. Later case reports and series demonstrating successful recovery from COVID-19 after ECMO have revived interest in this therapeutic modality, including the recent approval of ECMO for COVID-19 patients by the Food and Drug Administration (FDA). Here, we present the first reports of devastating intracranial hemorrhage as a complication of veno-venous (VV) ECMO in two COVID-19 patients. CLINICAL PRESENTATION: We performed a retrospective analysis of 2 cases of devastating intracranial hemorrhage in patients on VV-ECMO for the treatment of COVID-19. Collected data included clinical history, laboratory results, treatment, and review of all available imaging. Both patients demonstrated activated partial thromboplastin times (aPTT) within an appropriate therapeutic range. No risk factors that clearly predicted likelihood of this complication were identified.

conclusionUnderstanding the complications of ECMO in this cohort and developing therapeutic algorithms to aid in optimal patient selection will be critical in the limited resource setting experienced as a result of global pandemic. We propose the use of head computed tomography (CT) to identify devastating neurological complications as early as possible, aiding in the resource allocation of ECMO machines to the most appropriately selected patients.

Indexed as

AnticoagulantsBetacoronavirusCohort StudiesCoronavirus InfectionsCOVID-19Extracorporeal Membrane OxygenationFatal OutcomeFemaleHeparinHumansIntracranial HemorrhagesMaleMiddle AgedPandemicsPneumonia, ViralRespiratory Distress SyndromeAnticoagulantsHeparinCOVID-19Extracorporeal membrane oxygenationIntracranial hemorrhageIntraparenchymal hemorrhagePatient selectionResource allocationSARS-CoV-2

Identifiers

PMID32424429
PMCPMC7313766
OpenAlexW3025531615

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.