Carlos A Zamora1,2, Alexander Oshmyansky1, Melania Bembea3, Ivor Berkowitz3, Eman Alqahtani1, Shen Liu4, James McGree4, Steven Stern4, Thierry A G M Huisman1, Aylin Tekes5. 1. Russell H. Morgan Department of Radiology and Radiological Science, Division of Pediatric Radiology and Pediatric Neuroradiology, Johns Hopkins University School of Medicine, Baltimore, Maryland USA. 2. Department of Radiology, Division of Neuroradiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina USA. 3. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland USA. 4. Australian Research Council Center of Excellence for Mathematical and Statistical Frontiers, Queensland University of Technology, Melbourne, Victoria, Australia. 5. Russell H. Morgan Department of Radiology and Radiological Science, Division of Pediatric Radiology and Pediatric Neuroradiology, Johns Hopkins University School of Medicine, Baltimore, Maryland USA atekes1@jhmi.edu.
Abstract
OBJECTIVES: The purpose of this study was to determine the value of resistive index (RI) variability in predicting cerebrovascular complications during extracorporeal membrane oxygenation (ECMO). METHODS: This retrospective study included 36 infants treated by ECMO. The RI was measured on daily transfontanellar duplex sonography, obtained first without fontanel compression and then after gentle compression with the transducer. The age at ECMO cannulation, sex, gestational age at birth, method of delivery, indication, and type and duration of ECMO were recorded. RESULTS: There was a statistically significant difference in RI variability in infants who developed cerebrovascular complications as opposed to those who did not (P = .002). Resistive index variability of 10% or greater on any day was associated with an increased risk for cerebrovascular complications (P = .0482; χ2 = 3.9). Variability in the first 5 days was significantly higher than on following days (P < .0001). The age at ECMO cannulation showed a significant difference, with mean ± SD values of 1.1 ± 0.9 days in the complications group and 2.7 ± 2.2 days in the no-complications group (P = .043). CONCLUSIONS: Resistive index variability of 10% or greater on any day had a statistically significant risk of cerebrovascular complication development. Extracorporeal membrane oxygenation cannulation at younger than 3 days conferred an increased risk of cerebrovascular complications.
OBJECTIVES: The purpose of this study was to determine the value of resistive index (RI) variability in predicting cerebrovascular complications during extracorporeal membrane oxygenation (ECMO). METHODS: This retrospective study included 36 infants treated by ECMO. The RI was measured on daily transfontanellar duplex sonography, obtained first without fontanel compression and then after gentle compression with the transducer. The age at ECMO cannulation, sex, gestational age at birth, method of delivery, indication, and type and duration of ECMO were recorded. RESULTS: There was a statistically significant difference in RI variability in infants who developed cerebrovascular complications as opposed to those who did not (P = .002). Resistive index variability of 10% or greater on any day was associated with an increased risk for cerebrovascular complications (P = .0482; χ2 = 3.9). Variability in the first 5 days was significantly higher than on following days (P < .0001). The age at ECMO cannulation showed a significant difference, with mean ± SD values of 1.1 ± 0.9 days in the complications group and 2.7 ± 2.2 days in the no-complications group (P = .043). CONCLUSIONS: Resistive index variability of 10% or greater on any day had a statistically significant risk of cerebrovascular complication development. Extracorporeal membrane oxygenation cannulation at younger than 3 days conferred an increased risk of cerebrovascular complications.
Authors: Christopher J Rhee; Cristine Sortica da Costa; Topun Austin; Ken M Brady; Marek Czosnyka; Jennifer K Lee Journal: Pediatr Res Date: 2018-09-08 Impact factor: 3.756
Authors: Hanneke IJsselstijn; Maayke Hunfeld; Raisa M Schiller; Robert J Houmes; Aparna Hoskote; Dick Tibboel; Arno F J van Heijst Journal: Front Pediatr Date: 2018-06-26 Impact factor: 3.418