Abstract：
Regardless of the type, extracorporeal membrane oxygenation (ECMO) requires the use of large intravascular cannulas and results in multiple abnormalities including non-physiologic blood flow, hemodynamic perturbation, rapid changes in blood oxygen and carbon dioxide levels, coagulation abnormalities, and a significant systemic inflammatory response. Among other sequelae, neurologic complications are an important source of mortality and long-term morbidity. The frequency of neurologic complications varies and is likely underreported due to the high mortality rate. Neurologic complications in patients supported by ECMO include ischemic and hemorrhagic stroke, hypoxic brain injury, intracranial hemorrhage, and brain death. In addition to the disease process that necessitates ECMO, cannulation strategies and physiologic disturbances influence neurologic outcomes in this high-risk population. For example, the overall documented rate of neurologic complications in the venovenous ECMO population is lower, but a higher rate of intracranial hemorrhage exists. Meanwhile, in the venoarterial ECMO population, ischemia and global hypoperfusion seem to compose a higher percentage of neurologic complications. In what follows, the literature is reviewed to discuss the pathophysiology, incidence, risk factors, and outcomes related to short-term neurologic complications in patients supported by ECMO.
摘要：
无论哪种类型,体外膜氧合（ECMO）需要使用大型血管内插管，并导致多种异常，包括非生理性血流，血液动力学扰动，血氧和二氧化碳水平的快速变化，凝血异常，和明显的全身炎症反应。在其他后遗症中，神经系统并发症是死亡和长期发病率的重要来源.神经系统并发症的频率各不相同，并且由于高死亡率而可能被低估。ECMO支持的患者的神经系统并发症包括缺血性和出血性中风，缺氧性脑损伤，颅内出血,和脑死亡。除了需要ECMO的疾病过程之外，插管策略和生理紊乱会影响该高危人群的神经系统结局.例如,静脉-静脉ECMO人群中神经系统并发症的总体发生率较低,但颅内出血的发生率较高。同时,在静脉动脉ECMO人群中，缺血和全身灌注不足似乎构成较高比例的神经系统并发症。在接下来的事情中，回顾文献以讨论病理生理学，发病率,危险因素，以及与ECMO支持的患者的短期神经系统并发症相关的结局。
