Utility of neuroradiographic imaging in predicting outcomes after neonatal extracorporeal membrane oxygenation

Michael D. Rollins, Bradley A. Yoder, Kevin R. Moore, Douglas C. Barnhart, Chris Jones, Donald Null, Robert J. Digeronimo

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Background: The need for routine neuroimaging after extracorporeal membrane oxygenation (ECMO) and the optimal radiographic study remains unclear. We sought to evaluate the correlation between findings on head ultrasound (HUS) and magnetic resonance imaging (MRI) and determine the association of these findings to neurodevelopmental outcome. Methods: A retrospective review was performed (2003-2010) to identify neonates who had a MRI after ECMO. Each MRI was reviewed by a single pediatric neuroradiologist. Neurodevelopmental data was collected from the high-risk neonatal follow-up clinic. Results: Fifty neonates had a MRI (venoarterial 37, venovenous 13) after ECMO. HUS was abnormal in 24%, whereas MRI was abnormal in 62%. All infants with an abnormal HUS had an abnormal MRI, but an additional 50% of patients with a normal HUS had an abnormal MRI. Venoarterial ECMO was significantly associated with an abnormal MRI. Follow-up data was available for 26 neonates. The only predictor of abnormal neurodevelopment was the need for supplemental tube feeds at discharge. Conclusions: MRI identified significantly more abnormalities compared to routine HUS after neonatal ECMO. However, neither MRI nor HUS findings correlated with early neurodevelopmental outcome. Feeding ability at discharge was the overall best predictor of neurologic impairment in survivors.

Original languageEnglish (US)
Pages (from-to)76-80
Number of pages5
JournalJournal of Pediatric Surgery
Volume47
Issue number1
DOIs
StatePublished - Jan 1 2012
Externally publishedYes

Keywords

  • Extracorporeal membrane oxygenation
  • Magnetic resonance imaging
  • Neonates
  • Neurodevelopmental outcome
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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