Neuroimaging of brain injury in neonates treated with extracorporeal membrane oxygenation: Lessons learned from serial examinations

Lazar, Eric L.; Abramson, Sara J.; Weinstein, Stefanie; Stolar, Charles J.H.

doi:10.1016/0022-3468(94)90315-8

Cited by 54 publications

(38 citation statements)

References 11 publications

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“…Lago et al 7 noted that enlarged cerebrospinal fluid spaces, not solely widened intrahemispheric fissures (designated in the present study as ''atrophy''), detected on MRI post-ECMO were significantly associated with lower Bayley scores for both mental and psychomotor evaluations at 6 and 12 months. The occurrence of adverse neurodevelopmental outcome at 12 to 30 months was associated with moderate or severe neuroimaging abnormalities in ECMO-eligible survivors in a report by Vaucher et al 8 An overall incidence of 25% with severe CT/MRI brain abnormalities in our population is consistent with that found by Lazar et al 23 and Wiznitzer et al 24 The detection of peripheral supratentorial and posterior fossa lesions, and differentiating between infarcted and hemorrhagic lesions, comprise limitations of cranial sonography. 9 Taylor et al 9 detected 26 of 43 intracranial abnormalities (60%) with cranial sonography, whereas Wiznitzer et al 24 found HUS to have only a 25% sensitivity in detecting significant CNS lesions identified subsequently on MRI.…”

Section: Discussionsupporting

confidence: 87%

When Combined, Early Bedside Head Ultrasound and Electroencephalography Predict Abnormal Computerized Tomography or Magnetic Resonance Brain Images Obtained After Extracorporeal Membrane Oxygenation Treatment

et al. 2001

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Section: Discussionsupporting

confidence: 87%

When Combined, Early Bedside Head Ultrasound and Electroencephalography Predict Abnormal Computerized Tomography or Magnetic Resonance Brain Images Obtained After Extracorporeal Membrane Oxygenation Treatment

et al. 2001

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“…Cerebral injury, ICH as well as ischemia are revealed by imaging studies in 10% up to as high as 52% of the neonates [11,12,13]. Although ECMO has increased survival rates, the occurrence of hemorrhagic and ischemic cerebral lesions resulting in future neurological and neurodevelopmental dysfunction are of major concern [14,15].…”

Section: Cerebral Aspects Related To Neonatal Ecmomentioning

confidence: 99%

Cerebral Aspects of Neonatal Extracorporeal Membrane Oxygenation: A Review

2013

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Background: Neonatal extracorporeal membrane oxygenation (ECMO) is a lifesaving therapeutic approach in newborns suffering from severe, but potentially reversible, respiratory insufficiency, mostly complicated by neonatal persistent pulmonary hypertension. However, cerebral damage, intracerebral hemorrhage as well as ischemia belong to the most devastating complications of ECMO. Objectives: The objectives are to give insights into what is known from the literature concerning cerebral damage related to neonatal ECMO treatment for pulmonary reasons. Methods: A short introduction to ECMO indications and technical aspects of ECMO are provided for a better understanding of the process. The remainder of this review focuses on outcome and especially on (potential) risk factors for cerebral hemorrhage and ischemia during ECMO treatment. Results: Although neonatal ECMO treatment shows improved outcome compared to conservative treatment in cases of severe respiratory insufficiency, it is related to disturbances in various aspects of neurodevelopmental outcome. Risk factors for cerebral damage are either related to the patient's disease, EMCO treatment itself, or a combination of both. Conclusion: It is of ongoing importance to further understand pathophysiological mechanisms resulting in cerebral hemorrhage and ischemia due to ECMO and to develop neuroprotective strategies and approaches.

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“…When lesions do occur following carotid ligation they are more likely to be right sided 25 . Risk factors for such a lesion include cardiac arrest, severe hypoxia and hypotension at the time of cannulation 25 which results in a loss of cerebral autoregulation 26 allowing infarction during the 3-5 min that it takes for cerebral perfusion to be re-established from the left side 27 , thus the majority of right sided lesions could be avoided 28 , . It is our practice to primarily re-construct only those vessels which look healthy and non-friable at the time of de-cannulation, most vessels are hgated.…”

Section: Diagnosismentioning

confidence: 99%

Extra-corporeal membrane oxygenation for paediatric respiratory failure

Peek¹,

Sosnowski²

1997

British Medical Bulletin

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Extracorporeal membrane oxygenation (ECMO) uses modified cardiopulmonary bypass technology to provide prolonged respiratory or cardiorespiratory support for patients of all ages who have failed conventional intensive care management. The use of ECMO for neonatal respiratory failure is now evidence-based following the publication of the randomised UK Collaborative Trial. ECMO use in children remains more controversial, but overall survival of 71% is possible in a group of moribund patients whose mean PaO2/FIO 2 ratio of 61 mmHg accurately predicts death in studies of conventional ventilation.Common diagnoses for children requiring ECMO support are pneumonia and the acute respiratory distress syndrome (ARDS).Extracorporeal membrane oxygenation (ECMO) uses modified cardiopulmonary bypass technology to provide prolonged cardiorespiratory support in the intensive care unit. ECMO is usually considered when a patient has an estimated mortality of 80% despite maximal treatment. Survival rate with ECMO is 50-95% depending on diagnosis and age group. We will discuss the principles of ECMO for paediatric respiratory failure, based on the Extracorporeal Life Support Organisation (ELSO) registry, published literature and our own experience.

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Neuroimaging of brain injury in neonates treated with extracorporeal membrane oxygenation: Lessons learned from serial examinations

Cited by 54 publications

References 11 publications

When Combined, Early Bedside Head Ultrasound and Electroencephalography Predict Abnormal Computerized Tomography or Magnetic Resonance Brain Images Obtained After Extracorporeal Membrane Oxygenation Treatment

When Combined, Early Bedside Head Ultrasound and Electroencephalography Predict Abnormal Computerized Tomography or Magnetic Resonance Brain Images Obtained After Extracorporeal Membrane Oxygenation Treatment

Cerebral Aspects of Neonatal Extracorporeal Membrane Oxygenation: A Review

Extra-corporeal membrane oxygenation for paediatric respiratory failure

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