Incidence, Risk Factors, and Outcomes of Seizures in Extracorporeal Cardiopulmonary Resuscitation Patients: An Analysis of the Extracorporeal Life Support Organization Registry.

Extracorporeal cardiopulmonary resuscitation (ECPR) for refractory cardiac arrest is increasing in usage, but risk factors for seizures are largely unknown. We included adult ECPR patients in the Extracorporeal Life Support Organization Registry from 512 extracorporeal membrane oxygenation (ECMO) centers (2013-2023). Seizures were determined clinically or by electroencephalogram.

Early Relative Hypotension Below Noninvasive Cerebral Oximetry-Derived Optimal Blood Pressure Thresholds in Aneurysmal Subarachnoid Hemorrhage: A Pilot Study.

Objectives: Impairment in cerebral autoregulation (CA) after aneurysmal subarachnoid hemorrhage (aSAH) is associated with delayed cerebral ischemia (DCI) and poor outcomes. We assessed: 1) feasibility of defining CA-based optimal mean arterial pressure (MAPOpt) thresholds using noninvasive cerebral oximetry and 2) associations of relative hypotension below MAPOpt in the early brain injury (EBI) and pre-DCI phase with DCI and long-term outcomes after aSAH.

Design: Pilot observational study on a prospective cohort.

Exploring the Association Between Early PaCO Correction Speed and Cerebrovascular Autoregulation in a Porcine Model of Extracorporeal Resuscitation.

Background: Prior clinical research demonstrated that rapid reduction in arterial carbon dioxide (PaCO) levels during extracorporeal membrane oxygenation (ECMO) is associated with acute brain injury (ABI), which may be due to sudden cerebral vasoconstriction and impaired cerebrovascular autoregulation (CVAR). However, the causal relationship between rapid PaCO correction and its impact on ABI has not been firmly established due to the lack of high-quality evidence. We aimed to investigate whether rapid PaCO correction following extracorporeal cardiopulmonary resuscitation (ECPR) causes CVAR impairment and neuronal injury in a porcine model.

National Outcomes of Non-intubated Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplantation.

Background: Non-intubated veno-arterial extracorporeal membrane oxygenation (ECMO) has been described in patients with refractory cardiogenic shock, but there are limited data on outcomes of this technique as a bridge to heart transplantation. We investigated this practice in a national cohort.

Methods: Adult heart recipients bridged with ECMO 10/18/2018-09/30/2023 in the United Network for Organ Sharing database were categorized by use of ECMO and mechanical ventilation at transplant (ECMO+VENT vs.

Re-evaluating the association between thrombocytopenia and bleeding in extracorporeal membrane oxygenation (ECMO).

ObjectivesThe platelet trigger at which to transfuse platelets to prevent bleeding complications in patients supported with extracorporeal membrane oxygenation (ECMO) is unclear. We aimed to elucidate the association between platelet count and bleeding sequelae in this patient population.MethodsWe conducted a single-center retrospective study of all adult patients who received ECMO support from 2017 to 2022.

Epidemiological Patterns and Variability in Acute Brain Injury: A Multicenter Registry Analysis in South Korea's Neurocritical Care Units.

Background: Specialized neurocritical care (NCC) improves outcomes in acute brain injury (ABI), but significant variability exists in practices across and hospitals within South Korea's developing national NCC system. This study aims to assess clinical variability among patients with ABI across six tertiary NCC units (NCCUs) in South Korea and evaluate center-specific effects on clinical outcomes.

Methods: A multicenter registry of patients with ABI admitted to NCCUs between April 2023 and April 2024 was analyzed.

Inflammation and Neurological Outcomes in Cardiac Arrest - a Narrative Review of Serum Biomarker Investigations.

Background: Hypoxic-ischemic brain injury (HIBI) is a significant cause of disability following cardiac arrest (CA). Activation of the inflammatory cascade is central to HIBI pathophysiology and drives post-cardiac arrest syndrome (PCAS), which can induce further secondary brain injury. Although numerous studies have described this mechanism in preclinical models, translating this knowledge to therapeutic targets and neurological outcomes in humans is variable and incomplete.

Investigating the dynamics of intracranial pressure and cerebral autoregulation during extracorporeal cardiopulmonary resuscitation using a porcine model.

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) has emerged as a promising intervention for refractory cardiac arrest, with potential benefits in survival and neurological outcomes. However, the impact of ECPR's rapid, non-pulsatile restoration of cerebral blood flow on intracranial physiology and autoregulation remains poorly understood.

Methods: Using a porcine model, this study investigated the dynamics of intracranial pressure (ICP), cerebral autoregulation, and pulsatility during key experimental phases: Baseline, Fibrillation, ECMO, and ROSC.

Pulse Oximetry and Arterial Blood Gas Oxygen Saturation Discrepancies and Mortality in Extracorporeal Cardiopulmonary Resuscitation Patients: An Extracorporeal Life Support Organization Registry Analysis.

Objectives: Previous studies have shown that inaccurate peripheral oxygen saturation (Sp o2 ) readings compared with arterial oxygen saturation (Sa o2 ) may occur in extracorporeal membrane oxygenation (ECMO) patients. We hypothesized that a greater Sp o2 -Sa o2 discrepancy in extracorporeal cardiopulmonary resuscitation (ECPR) patients is associated with higher mortality due to unrecognized hypoxemia.

Design: Retrospective analysis.

Impact of Obesity on Neurologic Outcomes in Patients Undergoing Venoarterial Extracorporeal Membrane Oxygenation.

Objective: To investigate the impact of body mass index (BMI) on neurologic outcomes in venoarterial extracorporeal membrane oxygenation (VA-ECMO) DESIGN: Retrospective observational study SETTING: Single center PARTICIPANTS: Adults INTERVENTIONS: VA-ECMO MEASUREMENTS AND MAIN RESULTS: Obese (BMI≥30 kg/m²) and nonobese (BMI<30 kg/m²) patient groups were compared. The primary outcome was neurologic outcomes at discharge, with "good" (modified Rankin Scale [mRS] score 0-3) and "poor" (mRS score 4-6). Secondary outcomes were acute brain injury (ABI) and mortality.

Sex differences on cerebrovascular complications in hospitalized COVID-19 patients: a meta-analysis.

Background: Although pre-pandemic data suggest a higher stroke incidence in females, recent evidence suggests COVID-19-related strokes disproportionately affect males. Prior studies often analyzed stroke as a composite outcome without stratifying by biologically distinct subtypes. This systematic review and meta-analysis evaluated sex differences in the risk of ischemic and hemorrhagic stroke among hospitalized patients with COVID-19.

Enhancing Survival Prediction After Venoarterial Extracorporeal Membrane Oxygenation Using Machine Learning.

In-hospital mortality after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remains high. This study compared the performance of the Survival after Venoarterial ECMO (SAVE) score with machine learning (ML) models incorporating rich electronic medical record data to evaluate survival for patients on VA-ECMO support. We retrospectively reviewed adults undergoing VA-ECMO (2016-2022) at a single tertiary care center.

Using high-frequency oscillation to detect acute brain injury in extracorporeal membrane oxygenation supported patients.

Objective: This study aims to utilize HFO analysis to enhance existing SSEP modality and develop it as a bedside diagnostic tool for acute brain injury (ABI) detection in Extracorporeal Membrane Oxygenation (ECMO) patients.

Significance: Timely diagnosis of ABI in ECMO patients is challenging due to logistical complexities with computed tomography (CT) and magnetic resonance imaging (MRI). Integrating time-frequency analysis into routine SSEP monitoring for early ABI detection can facilitate timely medical decisions.

High-Granularity Machine Learning Prediction of Acute Brain Injury in Patients Receiving Venoarterial Extracorporeal Membrane Oxygenation.

Acute brain injury (ABI) is prevalent among patients undergoing venoarterial extracorporeal membrane oxygenation (VA-ECMO) and significantly impact recovery. Early prediction of ABI could enable timely interventions to prevent adverse outcomes, but existing predictive methods remain suboptimal. This study aimed to enhance ABI prediction using machine learning (ML) models and high-temporal-resolution granular data.

Acute stroke in children with immune thrombocytopenia: A systematic review and meta-analysis.

Immune thrombocytopenia (ITP) and immune-mediated thrombotic thrombocytopenic purpura (iTTP) are associated with haemostatic abnormalities. However, data on stroke including intracranial haemorrhage (ICH) and acute ischaemic stroke (AIS) in paediatric ITP and iTTP are limited. We aimed to primarily investigate the prevalence of ICH and AIS in paediatric patients with ITP and iTTP.

Temporal trends and risk factors associated with stroke mortality among cancer patients.

Background: This study aimed to explore the risk of stroke death (SD) in cancer patients, estimate rates, and identify risk factors associated with SD.

Methods: In this retrospective study, we used the 17 National Cancer Institute Surveillance, Epidemiology, and End Results registries (2000-2020). A total of 5,922,533 patients diagnosed with their first primary cancer were included.

Impact of Body Mass Index on Stroke in Extracorporeal Cardiopulmonary Resuscitation: Data from the Extracorporeal Life Support Organization Registry.

We aimed to characterize the impact of body mass index (BMI) on stroke in patients receiving extracorporeal cardiopulmonary resuscitation (ECPR). We queried the Extracorporeal Life Support Organization registry for patients receiving ECPR (2020-2024). Patients were categorized into five BMI groups: underweight (<18.

Role of Microneedles for Improved Treatment of Obesity: Progress and Challenges.

Obesity is a global metabolic health epidemic characterized by excessive lipid and fat accumulation, leading to severe conditions such as diabetes, cancer, and cardiovascular disease. Immediate attention and management of obesity-related health risks are most warranted. The imbalance between fat absorption, metabolic rate, and environmental and genetic factors is responsible for obesity.

A Novel, Interpretable Machine Learning Model to Predict Neurological Outcomes Following Venoarterial Extracorporeal Membrane Oxygenation.

Background: We used machine learning models incorporating rich electronic medical record (EMR) data to predict neurological outcomes after venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Methods: This was a retrospective review of adult (≥ 18 years) patients undergoing VA-ECMO between 6/2016 and 4/2022 at a single center. The primary outcome was good neurological outcome, defined as a modified Rankin Scale score of 0 to 3, evaluated at hospital discharge.

Effect of JNU 534 Supplementation on the Performance, Blood Parameters and Meat Characteristics of Inoculated Broilers.

Salmonellosis in broilers is a disease with considerable economic implications for the poultry industry. As a foodborne illness, it also poses a public health risk due to potential cross-contamination. Probiotics have been proposed as alternative feed additives aiming to enhance growth, livestock productivity, and overall health.

Patient-convenient long-term alopecia treatment PLGA microsphere-loaded candlelit microneedles.

Androgenetic alopecia (AGA) is characterized by chronic and progressive hair loss, with associated psychological factors intensifying the impact on patients. Current treatments, such as oral finasteride and topical minoxidil, have low bioavailability and numerous side effects. Dissolvable microneedles (DMNs) provide a promising alternative for drug delivery.

Prevalence and characteristics of acute ischemic stroke and intracranial hemorrhage in patients with immune thrombocytopenic purpura and immune thrombotic thrombocytopenic purpura: a systematic review and meta-analysis.

Background: There is an emerging understanding of the increased risk of stroke in patients with immune thrombocytopenic purpura (ITP) and immune thrombotic thrombocytopenic purpura (iTTP). We aimed to determine the prevalence and characteristics of acute ischemic stroke (AIS) and intracranial hemorrhage (ICH) in patients with ITP and iTTP in a systematic review and meta-analysis.

Methods: We used PubMed, Embase, Cochrane, Web of Science, and Scopus using text related to ITP, iTTP, stroke, AIS, and ICH from inception to 11/3/2023.

Postoperative Brain Attack: Current Perspectives and Future Directions.

The incidence of stroke after cardiac surgery poses significant challenges. This expert review piece explores current knowledge, challenges, future directions, and offers insights into improving patient outcomes through optimal prevention, early recognition, and management strategies. By addressing the challenges and opportunities in this area, we can enhance patient care, reduce long-term disabilities, and improve the overall quality of life for affected individuals.