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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal ECMO: neuroimaging and neurodevelopmental outcome
1Division of Diagnostic Imaging, Children's National Medical Center, 111 Michigan Ave., NW, Washington, DC 20010, USA. Dbulas@cnmc.org
Insights
Neonatal brain injury is a significant complication for infants treated with extracorporeal membrane oxygenation (ECMO). This review details imaging techniques, injury types, risk factors, and long-term functional outcomes in these vulnerable patients.
Area of Science:
- Neonatal neurology
- Pediatric critical care
- Medical imaging
Background:
- Intracranial injury is a frequent complication in neonates undergoing extracorporeal membrane oxygenation (ECMO).
- Neuroimaging abnormalities in ECMO infants range from 28% to 52%, varying with imaging methods and classification systems.
- Understanding these injuries is crucial for improving outcomes.
Purpose of the Study:
- To review common neuroimaging techniques for evaluating neonates on ECMO.
- To identify and describe various types of intracranial injuries reported in this population.
- To determine risk factors associated with neonatal brain injury during ECMO treatment.
Main Methods:
- Review of neuroimaging modalities used in ECMO neonates.
- Classification and description of reported intracranial injury types.
- Analysis of risk factors contributing to brain injury.
- Assessment of functional outcomes at 5 years of age.
Main Results:
- Discussion of imaging techniques like MRI and ultrasound.
- Categorization of injuries including hemorrhage, ischemia, and white matter damage.
- Identification of potential risk factors such as prematurity and duration of ECMO.
- Exploration of the long-term functional impact on survivors.
Conclusions:
- Neuroimaging plays a vital role in assessing brain injury in ECMO neonates.
- Identifying risk factors and injury patterns can guide preventative strategies.
- Long-term neurodevelopmental follow-up is essential for understanding the functional consequences of neonatal brain injury in ECMO survivors.
Abstract:
Intracranial injury continues to be a major complication associated with extracorporeal membrane oxygenation (ECMO)-treated neonates. The reported frequency of abnormal neuroimaging has ranged from 28% to 52%, depending on neuroimaging techniques and methods of classification. The purpose of this chapter is to describe types of imaging techniques commonly used to evaluate the ECMO neonate, to specify different types of injuries that have been reported, and to identify factors which increase the risk of injury. We will then describe the functional impact at age 5 years following neonatal brain injury among ECMO infants.
