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Ultrasound abnormalities in term infants on ECMO
A I Canady1, R D Fessler, M D Klein
1Neurosurgery Children's Hospital, Detroit, Mich.
Pediatric Neurosurgery
|July 1, 1993
Summary
Extracorporeal membrane oxygenation (ECMO) in infants can lead to brain abnormalities like extra-axial fluid collections and intracranial hemorrhage (ICH). Careful monitoring during ECMO is crucial for managing these neurological complications.
Area of Science:
- Neonatal Neurology
- Pediatric Critical Care Medicine
- Neuroimaging
Background:
- Neonates undergoing extracorporeal membrane oxygenation (ECMO) for severe respiratory failure face risks of neurological complications.
- Understanding the spectrum of brain abnormalities in this vulnerable population is critical for timely intervention.
Observation:
- Cranial ultrasounds of 29 neonates treated with ECMO were reviewed.
- Infants received ECMO for conditions including meconium aspiration syndrome, pulmonary hypertension, congenital diaphragmatic hernia, and sepsis.
Findings:
- Over half (58.6%) of neonates developed extra-axial fluid collections, with most being non-progressive.
- Intracranial hemorrhage (ICH) occurred in 34.5% of infants, predominantly in the caudate nucleus.
- Seizures were observed in 27.65% of neonates on ECMO, with 5 cases concurrent with ICH.
Implications:
- Cranial ultrasound is valuable for detecting neurological abnormalities in neonates on ECMO.
- Findings suggest a need for vigilant neuroimaging and seizure monitoring in infants receiving ECMO.
- Further research into the mechanisms and long-term outcomes of these ECMO-associated brain injuries is warranted.