Extracorporeal membrane oxygenation (ECMO) therapy in neonates can be complicated by brain injury. The risk has decreased over time as more experience has been gained, but injury can still occur.
Patient selection: neonate requiring ECMO support.
Risk factors for brain injury:
(1) veno-arterial ECMO (vs veno-venous)
(2) duration of ECMO, with significant risk when ECMO is used > 210 hours (8.75 days)
Types of injury:
(1) hemorrhage
(2) arterial ischemia stroke (infarcts)
(3) white matter changes
(4) volume loss
(5) ventriculomegaly and/or increased subarachnoid spaces
Injuries tend to be more common in the frontal and temporoparietal white matter.
The patient should be evaluated following ECMO:
(1) for changes in CNS lesions
(2) for neurodevelopmental defects
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Specialty: Pulmonology, Critical Care
