Brain Injury Associated With Neonatal Extracorporeal Membrane Oxygenation in The Netherlands

Raets, Marlou M. A.; Dudink, Jeroen; IJsselstijn, Hanneke; Heijst, Arno van; Lequin, Maarten H.; Houmes, Robert Jan; Wildschut, Enno D.; Reiss, Irwin K M; Govaert, Paul; Tibboel, Dick

doi:10.1097/pcc.0b013e3182a555ac

Cited by 55 publications

(37 citation statements)

References 32 publications

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“…CUS and MRI data were assessed for signs of preterm brain injury by experienced investigators independently (MMAR/PG for CUS and AP/MHL for MRI, with >20 years of experience in neonatal neuroimaging for PG and MHL) using a detailed classification system that covers for most common types of brain injury20 and has appropriately been described elsewhere 21. In all cases, consensus was reached between investigators.…”

Section: Methodsmentioning

confidence: 99%

Serial cranial ultrasonography or early MRI for detecting preterm brain injury?

Plaisier

Raets

Ecury-Goossen

et al. 2015

Arch Dis Child Fetal Neonatal Ed

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Section: Methodsmentioning

confidence: 99%

Serial cranial ultrasonography or early MRI for detecting preterm brain injury?

Plaisier

Raets

Ecury-Goossen

et al. 2015

Arch Dis Child Fetal Neonatal Ed

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“…Cranial ultrasound examinations had been performed before and serially during ECMO (started on daily basis, with lower frequency after stabilization). 4 On the basis of the national consensus on neonatal follow-up and the Dutch Ministry of Health's requirement to provide relevant data, the assessment protocol is the Dutch standard of care in ECMO follow-up. As a consequence, institutional review board approval was waived.…”

Section: Patients Procedures and Study Designmentioning

confidence: 99%

“…However, ECMO survivors may suffer from long-term morbidity, depending on the severity of primary underlying diagnoses, respiratory failure before ECMO, and several factors during ECMO. [1][2][3][4] Because more children survive the neonatal period, physical and neurodevelopmental morbidities at older ages are on the rise. [5][6][7][8][9] Thus far, most studies in ECMO survivors have focused on children's health status until age 5 years.…”

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confidence: 99%

Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

et al. 2016

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OBJECTIVE: To assess perceived motor competence, social competence, self-worth, healthrelated quality of life, and actual motor performancein 8-year-old survivors of neonatal extracorporeal membrane oxygenation (ECMO). METHODS:In a prospective nationwide study, 135 children completed the extended version of the "athletic competence" domain of the Self Perception Profile for Children (SPPC) called the m-CBSK (Motor supplement of the Competentie BelevingsSchaal voor Kinderen) to assess perceived motor competence, the SPPC, and the Pediatric Quality of Life Inventory (PedsQL), andwere tested with the Movement Assessment Battery for Children. SD scores (SDS) were used to compare with the norm. RESULTS:The mean (SD) SDS for perceived motor competence, social competence, and selfworth were all significantly higher than the norm: 0.18 (0.94), P = .03; 0.35 (1.03), P < .001; and 0.32 (1.08), P < .001, respectively. The total PedsQL score was significantly below the norm: mean (SD) SDS: -1.26 (1.53), P < .001. Twenty-two percent of children had actual motor problems. The SDS m-CBSK and actual motor performance did not correlate (r = 0.12; P = .17). The SDS m-CBSK significantly correlated with the athletic competence domain of the SPPC (r = 0.63; P < .001).CONCLUSIONS: Eight-year-old ECMO survivors feel satisfied with their motor-and social competence, despite impaired PedsQL scores and motor problems. Because motor problems in ECMO survivorsdeteriorate throughout childhood, clinicians should be aware that these patients may tend to "overrate" their actual motor performance. Education andstrict monitoring of actual motor performanceare important to enable timelyintervention.a Department of Orthopedics, Section of Physical Therapy, and b Intensive Care and Department of Pediatric Surgery, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, Netherlands; c Department of Rehabilitation, Pediatric Physical Therapy and Donders Institute, Radboud University Medical Center, Nijmegen, Netherlands; and d Department of Neonatology, Radboud University Medical Center-Amalia Children's Hospital, Nijmegen, Netherlands Ms Toussaint contributed to the conception and design, acquisition of data, analysis and interpretation of data, and writing of the fi rst draft; Dr van der Cammen-van Zijp contributed to the conception and design, acquisition of data, analysis and interpretation of data, writing of the fi rst draft, and critically revising the manuscript; Dr Janssen contributed to the conception and design, acquisition of data, and critically revising the manuscript; Dr Tibboel contributed to the conception and design and critically revising the manuscript; Dr Heijst contributed to conception and design and to acquisition of data and critically revised the manuscript; Dr IJsselstijn contributed to the conception and design, acquisition of data, interpretation of data, writing of the fi rst draft, and critically revising the manuscript; and all authors approved the fi nal manuscript as submitted. Currently, t...

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“…The ischemic stroke events during ECMO were located in the left hemisphere in 70% of the cases [24]. The reasons are likely multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

et al. 2017

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ObjectivesExtracorporeal membrane oxygenation support is indicated in severe and refractory respiratory or circulatory failures. Neurological complications are typically represented by acute ischemic or hemorrhagic lesions, which induce higher morbidity and mortality. The primary goal of this study was to assess the prognostic value of cerebral tissue oxygen saturation (StcO2) on mortality in neonates and young infants treated with ECMO. A secondary objective was to evaluate the association between StcO2 and the occurrence of cerebral lesions.Study designThis was a prospective study in infants < 3 months of age admitted to a pediatric intensive care unit and requiring ECMO support.MeasurementsThe assessment of cerebral perfusion was made by continuous StcO2 monitoring using near-infrared spectroscopy (NIRS) sensors placed on the two temporo-parietal regions. Neurological lesions were identified by MRI or transfontanellar echography.ResultsThirty-four infants <3 months of age were included in the study over a period of 18 months. The ECMO duration was 10±7 days. The survival rate was 50% (17/34 patients), and the proportion of brain injuries was 20% (7/34 patients). The mean StcO2 during ECMO in the non-survivors was reduced in both hemispheres (p = 0.0008 right, p = 0.03 left) compared to the survivors. StcO2 was also reduced in deceased or brain-injured patients compared to the survivors without brain injury (p = 0.002).ConclusionStcO2 appears to be a strong prognostic factor of survival and of the presence of cerebral lesions in young infants during ECMO.

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Brain Injury Associated With Neonatal Extracorporeal Membrane Oxygenation in The Netherlands

Cited by 55 publications

References 32 publications

Serial cranial ultrasonography or early MRI for detecting preterm brain injury?

Serial cranial ultrasonography or early MRI for detecting preterm brain injury?

Perceived Motor Competence Differs From Actual Performance in 8-Year-Old Neonatal ECMO Survivors

Prognostic value of cerebral tissue oxygen saturation during neonatal extracorporeal membrane oxygenation

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