Gannon C M, Kornhauser M S, Gross G W, Wiswell T E, Baumgart S, Streletz L J, Graziani L J, Spitzer A R
Departments of Pediatrics, Radiology, and Neurology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
J Perinatol. 2001 Oct-Nov;21(7):451-5. doi: 10.1038/sj.jp.7210593.
Definitive neuroimaging of the brain using computerized tomography (CT) or magnetic resonance imaging (MRI) in extracorporeal membrane oxygenation (ECMO)-treated infants must be delayed until after this therapy is completed. Bedside head ultrasound (HUS) and electroencephalography (EEG) studies during ECMO, if highly correlated with later definitive neuroimaging, might be used to affect the acute clinical care and early parental counseling of infants with severe cardiorespiratory failure. One hundred and sixty ECMO-treated patients had both bedside EEG and HUS studies performed during ECMO, as well as a later CT or MRI study prior to hospital discharge. There was a significant difference in CT or MRI findings among patients having normal studies on both the HUS and EEG, compared to those having an abnormality on either the HUS or the EEG, and compared to those having abnormalities on both studies. In ECMO-treated infants, the combination of a normal bedside HUS and an EEG without marked abnormalities is highly predictive of normal post-ECMO CT and MRI neuroimaging studies.
对于接受体外膜肺氧合(ECMO)治疗的婴儿,使用计算机断层扫描(CT)或磁共振成像(MRI)进行明确的脑部神经成像检查必须推迟到该治疗结束后。如果在ECMO期间进行的床旁头部超声(HUS)和脑电图(EEG)研究与后期明确的神经成像高度相关,则可用于影响患有严重心肺功能衰竭婴儿的急性临床护理和早期家长咨询。160例接受ECMO治疗的患者在ECMO期间同时进行了床旁EEG和HUS检查,以及出院前的后期CT或MRI检查。与HUS和EEG检查均正常的患者相比,HUS或EEG检查有异常的患者以及两项检查均有异常的患者,其CT或MRI检查结果存在显著差异。在接受ECMO治疗的婴儿中,床旁HUS正常且EEG无明显异常的组合高度预测ECMO后CT和MRI神经成像检查结果正常。