AUTHOR=Thudium Marcus , Kappler Jochen , Oremek Maximilian J. G. , Ehrentraut Stefan Felix , Kornilov Evgeniya , Marinova Milka , Putensen Christian , Soehle Martin , Schewe Jens-Christian 

TITLE=Increased impairment of cerebral autoregulation in COVID-19 associated pulmonary failure requiring extracorporeal membrane oxygenation

JOURNAL=Frontiers in Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2024.1423241

DOI=10.3389/fmed.2024.1423241

ISSN=2296-858X

ABSTRACT=<sec id="sec1"><title>Introduction</title><p>Cerebrovascular complications are feared but also commonly reported in patients with COVID-19 requiring extracorporeal membrane oxygenation (ECMO) support therapy. Besides other reasons, a connection between impaired cerebral autoregulation and SARS-CoV-2 infection as a mechanism for an increase in cerebrovascular complications has been hypothesized.</p></sec><sec id="sec2"><title>Methods</title><p>In an observational single-center study, we investigated a cohort of 48 patients requiring veno-venous ECMO support therapy with (<italic>n</italic> = 31) and without SARS-CoV-2 infection (<italic>n</italic> = 17). Cerebral autoregulation was assessed with the cerebral oximetry-derived autoregulation index (ORx) based on a moving correlation between arterial pressure and cerebral oximetry.</p></sec><sec id="sec3"><title>Results</title><p>Patients with ECMO support therapy and SARS-CoV-2 experienced more time with impaired cerebral autoregulation than without SARS-CoV-2 [17 ± 9 vs. 13 ± 9% (<italic>p</italic> = 0.027)]. Patients with SARS-CoV-2 suffering from cerebrovascular complications had more time with impaired autoregulation than non SARS-CoV-2 patients with these complications (19 ± 9 vs. 10 ± 4%, <italic>p</italic> = 0.032).</p></sec><sec id="sec4"><title>Conclusion</title><p>Our results suggest a connection between SARS-CoV-2 and impaired cerebral autoregulation as well as cerebrovascular complications in SARS-CoV-2 patients.</p></sec>