Impairment of cerebral autoregulation in pediatric extracorporeal membrane oxygenation associated with neuroimaging abnormalities

Fenghua Tian, Michael Craig Morriss, Lina Chalak, Ramgopal Venkataraman, Chul Ahn, Hanli Liu, Lakshmi Raman

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Extracorporeal membrane oxygenation (ECMO) is a life-supporting therapy for critically ill patients with severe respiratory and/or cardiovascular failure. Cerebrovascular impairment can result in hemorrhagic and ischemic complications commonly seen in the patients supported on ECMO. We investigated the degree of cerebral autoregulation impairment during ECMO as well as whether it is predictive of neuroimaging abnormalities. Spontaneous fluctuations of mean arterial pressure (MAP) and cerebral tissue oxygen saturation (SctO2) were continuously measured during the ECMO run. The dynamic relationship between the MAP and SctO2 fluctuations was assessed based on wavelet transform coherence (WTC). Neuroimaging was conducted during and/or after ECMO as standard of care, and the abnormalities were evaluated based on a scoring system that had been previously validated among ECMO patients. Of the 25 patients, 8 (32%) had normal neuroimaging, 7 (28%) had mild to moderate neuroimaging abnormalities, and the other 10 (40%) had severe neuroimaging abnormalities. The degrees of cerebral autoregulation impairment quantified based on WTC showed significant correlations with the neuroimaging scores (R=0.66; p<0.0001). Evidence that cerebral autoregulation impairment during ECMO was related to the patients' neurological outcomes was provided.

Original languageEnglish (US)
Article number041410
JournalNeurophotonics
Volume4
Issue number4
DOIs
StatePublished - Oct 1 2017

Keywords

  • blood pressure
  • cerebral autoregulation
  • cerebral tissue oxygen saturation
  • extracorporeal membrane oxygenation
  • neurological injury
  • wavelet transform coherence

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Neuroscience (miscellaneous)

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