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KMID : 0604020140290020070
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Korean Journal of Critical Care Medicine
2014 Volume.29 No. 2 p.70 ~ p.76
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Efficacy of Electroencephalographic Monitoring for the Evaluation of Intracranial Injury during Extracorporeal Membrane Oxygenation Support in Neonates and Infants
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Jeong In-Seok
Woo Young-Jong
Kim Do-Wan
Kim Nam-Yeol
Cho Hwa-Jin
Ma Jae-Sook
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Abstract
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Background: Neurological complications are a serious concern during extracorporeal membrane oxygenation (ECMO) support in neonatesand infants. However, evaluating brain injury during ECMO has limitations. Herein, we report our experience with bedside electroencephalographicmonitoring during ECMO support and compared this to post-ECMO brain imaging studies and immediate neurologicoutcomes.
Methods: We retrospectively reviewed the data for 18 children who underwent ECMO. From these subjects, we reviewed the medicalrecords of 10 subjects who underwent bedside EEG monitoring during ECMO support. We collected data on patient demographics, clinicaldetails of the ECMO course, electroencephalographic monitoring, brain imaging results, and neurologic outcomes.
Results: The median age was 4 months (range: 7 days-22 months), the median weight was 5 (3.6-12) kg, and the median length ofECMO therapy was 86 (27-206) hours. Eight patients (80%) were weaned successfully, and seven (70%) survived to discharge. Thosewith normal to mildly abnormal electroencephalographic findings had non-specific to mildly abnormal brain computed tomographyfindings and no neurologic impairment. Those patients with a moderately to severely abnormal electroencephalograph had markedly abnormalbrain computed tomography findings and remained neurologically impaired.
Conclusions: Normal electroencephalographic findings are closely related to normal or mild neurologic impairment. Our results indicatethat electroencephalographic monitoring during ECMO support can be a feasible tool for evaluating brain injury although furtherprospective studies are needed.
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KEYWORD
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electroencephalography, extracorporeal membrane oxygenation, infant, neonate, neuroimaging
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