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

Journal of Perinatology volume 21, pages 451–455 (2001)Cite this article

Abstract

Definitive neuroimaging of the brain using computerized tomography (CT) or magnetic resonance imaging (MRI) in extracorporeal membrane oxygenation (ECMO)–treated infants must be delayed until after this therapy is completed. Bedside head ultrasound (HUS) and electroencephalography (EEG) studies during ECMO, if highly correlated with later definitive neuroimaging, might be used to affect the acute clinical care and early parental counseling of infants with severe cardiorespiratory failure. One hundred and sixty ECMO-treated patients had both bedside EEG and HUS studies performed during ECMO, as well as a later CT or MRI study prior to hospital discharge. There was a significant difference in CT or MRI findings among patients having normal studies on both the HUS and EEG, compared to those having an abnormality on either the HUS or the EEG, and compared to those having abnormalities on both studies. In ECMO-treated infants, the combination of a normal bedside HUS and an EEG without marked abnormalities is highly predictive of normal post-ECMO CT and MRI neuroimaging studies.

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References

  1. Schumacher RE Risks of neonatal ECMO In: Arensman RM, Cornish JD, editors. Extracorporeal Life Support Boston: Blackwell 1993

  2. Gleason CA ECMO and the brain In: Arensman RM, Cornish JD, editors. Extracorporeal Life Support Boston: Blackwell 1993

  3. Volpe JJ Intracranial hemorrhage In: Neurology of the Newborn. 3rd ed Philadelphia: W.B. Saunders 1995

  4. Glass P, Miller M, Short B Morbidity for survivors of extracorporeal membrane oxygenation: neurodevelopmental outcome Pediatrics 1989 83 72–8

    CAS  PubMed  Google Scholar 

  5. Taylor GA, Glass P, Fitz CR, et al Neurologic status in infants treated with extracorporeal membrane oxygenation: correlation of imaging findings with developmental outcome Radiology 1987 165 679–82

    Article  CAS  Google Scholar 

  6. Revenis ME, Glass P, Short BL Mortality and morbidity rates among lower birth weight infants (2000 to 2500 grams) treated with extracorporeal membrane oxygenation J Pediatr 1992 121 452–8

    Article  CAS  Google Scholar 

  7. Lago P, Rebsamen S, Clancy RR, et al MRI, MRA, and neurodevelopmental outcome following neonatal ECMO Pediatr Neurol 1995 12 294–304

    Article  CAS  Google Scholar 

  8. Vaucher YE, Dudell GG, Bejar R, et al Predictors of early childhood outcome in candidates for extracorporeal membrane oxygenation J Pediatr 1996 128 109–17

    Article  CAS  Google Scholar 

  9. Taylor GA, Fitz CR, Miller MK, et al Intracranial abnormalities in infants treated with extracorporeal membrane oxygenation: imaging with US and CT Radiology 1987 165 675–8

    Article  CAS  Google Scholar 

  10. Campbell LR, Bunyapen C, Gangarosa ME, et al Significance of seizures associated with extracorporeal membrane oxygenation J Pediatr 1991 119 789–92

    Article  CAS  Google Scholar 

  11. Streletz LJ, Bej MD, Graziani LJ, et al Utility of serial EEG's in neonates during extracorporeal membrane oxygenation Pediatr Neurol 1992 8 190–6

    Article  CAS  Google Scholar 

  12. Hahn JS, Vaucher Y, Bejar R, Coen RW Electroencephalographic and neuroimaging findings in neonates undergoing extracorporeal membrane oxygenation Neuropediatrics 1993 24 19–24

    Article  CAS  Google Scholar 

  13. Korinthenberg R, Kachel W, Koelfen W, et al Neurologic findings in newborn infants after extracorporeal membrane oxygenation, with special reference to the EEG Dev Med Child Neurol 1993 35 249–57

    Article  CAS  Google Scholar 

  14. Graziani LJ, Streletz LJ, Baumgart S, et al Predictive value of neonatal electroencephalograms before and during extracorporeal membrane oxygenation J Pediatr 1994 125 969–75

    Article  CAS  Google Scholar 

  15. Lombroso CT, Holmes GL Value of the EEG in neonatal seizures J Epilepsy 1993 6 39–70

    Article  Google Scholar 

  16. Holmes G, Rowe J, Hafford J, et al Prognostic value of the electroencephalogram in neonatal asphyxia Electroencephalogr Clin Neurophysiol 1982 53 60–72

    Article  CAS  Google Scholar 

  17. Hrachovy RA, Mizrahi EM, Kellaway P Electroencephalography of the newborn In: Daly DD, Pedley TA, editors. Current Practice of Clinical Electroencephalography. 2nd ed New York: Raven Press 1990

  18. Papile LA, Burnstein J, Burnstein R, et al Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 grams J Pediatr 1978 92 529–34

    Article  CAS  Google Scholar 

  19. Tharp BR, Laboyrie PM The incidence of EEG abnormalities and outcome of infants paralyzed with neuromuscular blocking agents Crit Care Med 1983 11 926–9

    Article  CAS  Google Scholar 

  20. Graziani LJ, Baumgart S, Desai S, Stanley C, Gringlas M, Spitzer AR Clinical antecedents of neurologic and audiologic abnormalities in survivors of neonatal ECMO J Child Neurol 1997 12 415–22

    Article  CAS  Google Scholar 

  21. Extracorporeal Life Support Organization: Guidelines for Neonatal ECMO Ann Arbor, Michigan: University of Michigan 1995

  22. Kornhauser MS, Desai SA, Stanley CW, et al Correlation of CT, MRI and EEG with developmental outcome in newborns treated with ECMO (#1561) Pediatr Res 1995 37 263A

    Google Scholar 

  23. Lazar EL, Abramson SJ, Weinstein S, Stolar CJ Neuroimaging of brain injury in neonates treated with extracorporeal membrane oxygenation: lessons learned from serial examinations J Pediatr Surg 1994 29 186–91

    Article  CAS  Google Scholar 

  24. Wiznitzer M, Masaryk T, Lewin J, et al Parenchymal and vascular magnetic resonance imaging of the brain after extracorporeal membrane oxygenation AJDC 1990 144 1323–6

    CAS  PubMed  Google Scholar 

  25. Hofkosh D, Thompson AE, Nozza RJ Ten years of extracorporeal membrane oxygenation: neurodevelopmental outcome Pediatrics 1991 87 549–55

    CAS  PubMed  Google Scholar 

  26. Biagioni E, Mercuri E, Rutherford M, et al Combined use of electroencephalogram and magnetic resonance imaging in full-term neonates with acute encephalopathy Pediatrics 2001 107 461–8

    Article  CAS  Google Scholar 

  27. Scher MS, Aso K, Beggarly ME, et al Electrographic seizures in preterm and fullterm neonates: clinical correlates, associated brain lesions and risk for neurologic sequelae Pediatrics 1993 91 128–34

    CAS  PubMed  Google Scholar 

  28. Scher MS Midline encephalographic abnormalities and cerebral lesions in the newborn brain J Child Neurol 1988 3 229

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Departments of Pediatrics, Radiology, and Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, USA

    Catherine M Gannon MD, Michael S Kornhauser MD, George W Gross MD, Thomas E Wiswell MD, Stephen Baumgart MD, Leopold J Streletz MD, Leonard J Graziani MD & Alan R Spitzer MD

Authors
  1. Catherine M Gannon MD
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  2. Michael S Kornhauser MD
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  3. George W Gross MD
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  4. Thomas E Wiswell MD
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  5. Stephen Baumgart MD
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  6. Leopold J Streletz MD
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  7. Leonard J Graziani MD
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  8. Alan R Spitzer MD
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Additional information

Supported, in part, by NIH NS27463 and NS21453, and presented, in part, at the Society for Pediatric Research Meeting, San Diego, CA, May 1995.

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Gannon, C., Kornhauser, M., Gross, G. et al. When Combined, Early Bedside Head Ultrasound and Electroencephalography Predict Abnormal Computerized Tomography or Magnetic Resonance Brain Images Obtained After Extracorporeal Membrane Oxygenation Treatment. J Perinatol 21, 451–455 (2001). https://doi.org/10.1038/sj.jp.7210593

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