Subependymal (grade 1) intracranial hemorrhage in neonates on extracorporeal membrane oxygenation. Frequency and patterns of evolution.

Publication/Presentation Date

10-1-1994

Abstract

Intracranial hemorrhage (ICH) is a potential contraindication to extracorporeal membrane oxygenation (ECMO) therapy in neonates, since systemic anticoagulation required during ECMO may increase the incidence and progression of ICH. To determine the frequency and the pattern of evolution of subependymal hemorrhage (SEH) (grade 1 ICH) in neonates on ECMO, the daily head ultrasound (HUS) examinations obtained as part of a prospective neurologic evaluation protocol in 212 ECMO patients were reviewed. Forty-three patients (20%) had a total of 65 SEHs. Twenty-two infants had bilateral SEH. Twenty-eight infants developed 38 SEHs during ECMO bypass after pre-ECMO HUS showed no evidence of ICH. An additional 18 neonates had a total of 22 SEHs demonstrated on pre-ECMO HUS. No pre-ECMO HUS was performed in four infants having a total of five SEHs first identified during ECMO bypass. Of the 65 SEHs, 59 (91%) remained stable or resolved during ECMO, while six (9%) evolved during ECMO--three to grade 2, one to grade 3, and two to grade 4 ICH. Our data suggest that SEH should not be considered a contraindication to ECMO bypass and very infrequently will progress significantly during ECMO.

Volume

33

Issue

10

First Page

583

Last Page

587

ISSN

0009-9228

Disciplines

Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology

PubMedID

7813136

Department(s)

Department of Radiology and Diagnostic Medical Imaging

Document Type

Article

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