Neonatal ECMO: neuroimaging and neurodevelopmental outcome

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.