☆ 4.1 Article

Pediatric ECLS Neurologic management and outcomes

Seminars in Pediatric Surgery (2023)

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Summary: Neuromonitoring and neurocognitive/neurodevelopmental follow-up are critically important during and after ECMO. However, there is significant variability in practice across Europe, and only a minority of centers have structured longitudinal follow-up programs. Guidelines and minimum standards should be developed to inform local protocols.

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Summary: This study aimed to investigate the incidence of seizures and associated short-term mortality in children undergoing extracorporeal membrane oxygenation (ECMO). The results showed that the incidence of seizures in children requiring ECMO was 15%, with the majority of seizures being subclinical. Children receiving extracorporeal cardiopulmonary resuscitation (ECPR) had a higher incidence of seizures compared to those with respiratory and cardiac indications. Seizures were more frequent in patients undergoing venoarterial (VA) ECMO compared to venovenous (VV) ECMO. Seizures were associated with increased short-term mortality.

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A Systematic Review of Clinical Outcomes After Carotid Artery Ligation Versus Carotid Artery Reconstruction Following Venoarterial Extracorporeal Membrane Oxygenation in Infants and Children

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Poornima Pandiyan et al.

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Incidence and predictors of brain infarction in neonatal patients on extracorporeal membrane oxygenation: an observational cohort study

Sarah Kopfer et al.

Summary: A retrospective cohort study was conducted to determine the incidence and predictors of brain infarctions in neonatal patients treated with ECMO. The study found that the incidence of brain infarctions in neonatal ECMO patients may be higher than previously understood. Several predictors, such as high mortality score, sepsis, ECMO mode conversion, continuous renal replacement therapy, and extracranial thrombosis, were identified.

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Risk Factors for Brain Injury in Newborns Treated with Extracorporeal Membrane Oxygenation

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Summary: Patients on VA ECMO and with longer ECMO duration have an increased risk of brain injury severity. The study suggests that improvements in care may be reducing the incidence of brain injury in neonatal ECMO patients over time.

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Morbidity of conversion from venovenous to venoarterial ECMO in neonates with meconium aspiration or persistent pulmonary hypertension

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Association of Cerebral Oxymetry with Short-Term Outcome in Critically ill Children Undergoing Extracorporeal Membrane Oxygenation

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Summary: The study found that impaired cerebral oxygenation during pediatric ECMO was associated with poor short-term outcomes, while cerebral oxygenation above 80% seemed to be protective. Monitoring of cerebral oxygenation may be important to assess the risk of brain injury in children undergoing ECMO.

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Pediatric and neonatal extracorporeal life support: current state and continuing evolution

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Changes in Venoarterial Extracorporeal Membrane Oxygenation Management Over Time Could Explain a More Frequent Diagnosis of Neurological Complications in That Population

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BL Short

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Seizures as a predictor of long-term neurodevelopmental outcome in survivors of neonatal extracorporeal membrane oxygenation (ECMO)

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