Korean J Crit Care Med.  2014 May;29(2):70-76. 10.4266/kjccm.2014.29.2.70.

Efficacy of Electroencephalographic Monitoring for the Evaluation of Intracranial Injury during Extracorporeal Membrane Oxygenation Support in Neonates and Infants

• Jeong IS
• Woo YJ
• Kim DW
• Kim NY
• Cho HJ
• Ma JS

• KMID: 2227764
• DOI: http://doi.org/10.4266/kjccm.2014.29.2.70

Abstract

BACKGROUND
Neurological complications are a serious concern during extracorporeal membrane oxygenation (ECMO) support in neonates and infants. However, evaluating brain injury during ECMO has limitations. Herein, we report our experience with bedside electroencephalographic monitoring during ECMO support and compared this to post-ECMO brain imaging studies and immediate neurologic outcomes.
METHODS
We retrospectively reviewed the data for 18 children who underwent ECMO. From these subjects, we reviewed the medical records of 10 subjects who underwent bedside EEG monitoring during ECMO support. We collected data on patient demographics, clinical details 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 of ECMO therapy was 86 (27-206) hours. Eight patients (80%) were weaned successfully, and seven (70%) survived to discharge. Those with normal to mildly abnormal electroencephalographic findings had non-specific to mildly abnormal brain computed tomography findings and no neurologic impairment. Those patients with a moderately to severely abnormal electroencephalograph had markedly abnormal brain computed tomography findings and remained neurologically impaired.
CONCLUSIONS
Normal electroencephalographic findings are closely related to normal or mild neurologic impairment. Our results indicate that electroencephalographic monitoring during ECMO support can be a feasible tool for evaluating brain injury although further prospective studies are needed.

Keyword

electroencephalography; extracorporeal membrane oxygenation; infant; neonate; neuroimaging

MeSH Terms

Brain
Brain Injuries
Child
Demography
Electroencephalography
Extracorporeal Membrane Oxygenation*
Humans
Infant*
Infant, Newborn*
Medical Records
Neuroimaging
Retrospective Studies