HITS by TCD in Patients with V-A ECMO

概要

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We detected HITS in patients with a risk of embolic stroke and V-A ECMO. HITS was detected by TC2020 (EME) with 2.0MHz probe at MCA artery for 15min. HITS was never detected in healthy volunteers (n=20). HITS count in patients with no cerebrovascular disease was 0.5 (n=17). The count in patients receiving open heart surgery without mechanical valve was 0.08 (n=11). In cerebral infarction, HITS was frequently detected, and the counts in patients having antiplatelets (3, n=20) was significantly lower than that in those without antiplatelets (13, n=22) (p<0.01). In mechanical valve replacement, HITS was more frequently than cerebral infarction, and the count in patients suffering from cerebral infarction (83, n=8) was significantly higher her than that in those without a history of stroke (7, n=42) (p<0.01). HITS in patients with V-A ECMO was 118 (ACT=200 sec, n=6) and the count reduced by prolonging ACT. In V-V ECMO, HITS was not detected. HITS was frequently detected in patients with a risk of cerebral infarction. Furthermore, HITS count appeared to be reduced by antiplatelet or anticoagulation therapy. HITS may indicate a risk of embolic event and useful for managing of V-A ECMD.