Children supported by Extra-Corporeal Membrane Oxygenation (ECMO) present a high risk of neurological complications and cerebral autoregulation (CA) impairment may be a risk factor. Our first objective is to investigate the feasibility of CA continuous monitoring during ECMO treatment. The second objective is to analyze the relationship between CA impairment and neurological outcome.
Patients : All children treated by ECMO in the PICU of the Universitary hospital of Nantes, France and of IRCCS Giannina Gaslini Institute, Genoa, Italy Measurements: A correlation coefficient between the variations of regional cerebral oxygen saturation (rScO2) as a surrogate of cerebral blood flow and the variations of arterial blood pressure (ABP) is calculated as an index of autoregulation (cerebral oxygenation index (COx), ICM+ software®). CA is monitored either on left (COxl) or both sides. A COx \> 0.3 is considered as critical. Neurological outcome is assessed by the onset of an acute neurologic event (ANE) during the ECMO run.
Study Type
OBSERVATIONAL
Enrollment
30
ECMO for hemodynamic or respiratory indication
University Hospital
Nantes, Loire-Atlantique, France
Feasibility of continuous cerebral autoregulation monitoring
Percentage of time when cerebral autoregulation metrics are available. cerebral autoregulation metrics variations under Extra-Corporeal Membrane Oxygenation
Time frame: 12 hours before Extra-Corporeal Membrane Oxygenation
Feasibility of continuous cerebral autoregulation monitoring
Percentage of time when cerebral autoregulation metrics are available. cerebral autoregulation metrics variations under Extra-Corporeal Membrane Oxygenation
Time frame: During Extra-Corporeal Membrane Oxygenation
Feasibility of continuous cerebral autoregulation monitoring
Percentage of time when cerebral autoregulation metrics are available. cerebral autoregulation metrics variations under Extra-Corporeal Membrane Oxygenation
Time frame: 12 hours after Extra-Corporeal Membrane Oxygenation
Correlation between cerebral autoregulation metrics and neurological outcome
Correlation between the percentage of time spent in critical region of cerebral autoregulation and the onset of an acute neurological event (stroke and/or seizures and/or brain death) or not
Time frame: 12 hours after Extra-Corporeal Membrane Oxygenation
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