Using cerebral regional oxygen saturation and amplitude-integrated electroencephalography in neonates on extracorporeal membrane oxygenation: preliminary experience from a single center.

BMC Pediatr

Department of Cardiac Surgery, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.

Published: September 2024

AI Article Synopsis

  • This study investigates the efficacy of monitoring cerebral regional oxygen saturation (CrSO) and amplitude-integrated electroencephalography (aEEG) in predicting neurological outcomes for neonates undergoing extracorporeal membrane oxygenation (ECMO).
  • An analysis of 18 neonates on veno-arterial ECMO revealed that those with better CrSO stability and less significant reductions typically had normal brain MRI results post-treatment.
  • Findings suggest that CrSO and aEEG could be valuable as routine assessments to help predict neurological health in neonates receiving ECMO support.

Article Abstract

Objective: This study aims to evaluate the application value in neurological outcome of cerebral regional oxygen saturation (CrSO) and amplitude-integrated electroencephalography (aEEG) monitoring during neonatal extracorporeal membrane oxygenation (ECMO) courses.

Methods: We retrospectively analyzed 18 neonates receiving veno-arterial ECMO (V-A ECMO) support at our hospital from July 2021 to December 2022. Continuous monitoring of CrSO and brain electrical activity was conducted using near-infrared spectroscopy (NIRS) and aEEG throughout the ECMO treatment. We collected and analyzed related clinical data.

Results: Among the 11 survivors, 5 were categorized as the normal group (N group) and 6 as the abnormal group (AN group) based on post-ECMO brain MRI outcomes. The N group exhibited shorter time percentage of significant CrSO reduction (> 25% from baseline or absolute value < 40%), better fractional tissue oxygen extraction (FTOE) rates, and more stable mean percentage changes in CrSO compared to the AN group. Neonates in the N group predominantly showed mildly abnormal aEEG readings, with one patient displaying disrupted sleep-wake cycles. This particular patient also had more significant CrSO reduction and poorer FTOE compared to others in the N group. Additionally, the Test of Infant Motor Performance (TIMP) scores indicated hypoevolutism in this patient before discharge, while others in the N group had normal TIMP scores. In the AN group, 4 exhibited moderate and 2 severe aEEG abnormalities; 5 had hypoevolutism TIMP scores, and 1 with moderate aEEG abnormalities maintained a normal TIMP score, exhibiting lesser CrSO reduction and improved FTOE.

Conclusion: CrSO and aEEG monitoring show potential as routine assessments for neurological outcomes during neonatal ECMO. In our cohort, a tendency was observed where neonates with greater reductions in CrSO and more severe aEEG abnormalities experienced poorer neurological outcomes.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406793PMC
http://dx.doi.org/10.1186/s12887-024-05062-wDOI Listing

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