Utility of Routine Head Ultrasounds in Infants on Extracorporeal Life Support: When is it Safe to Stop Scanning?. Issue 9 (28th December 2021)

• Record Type: Journal Article
• Authors: Theodorou, Christina M.; Guenther, Timothy M.; Honeychurch, Kaitlyn L.; Kenny, Laura; Mateev, Stephanie N.; Raff, Gary W.; Beres, Alana L.
• Is Part Of: ASAIO journal. Volume 68:Issue 9(2022)
• Page Start: 1191
• Page End: 1196
• Publication Date: 2021-12-28
• Subjects: extracorporeal life support -- pediatric critical care -- intracranial hemorrhage -- ultrasonography; Artificial organs -- Periodicals; 617
• DOI: 10.1097/MAT.0000000000001641
• Languages: English
• ISSNs: 1058-2916

Abstract

Abstract : Intracranial hemorrhage (ICH) can be a devastating complication of extracorporeal life support (ECLS); however, studies on the timing of ICH detection by head ultrasound (HUS) are from 2 decades ago, suggesting ICH is diagnosed by day 5 of ECLS. Given advancements in imaging and critical care, our aim was to evaluate if the timing of ICH diagnosis in infants on ECLS support has changed. Patients <6 months old undergoing ECLS 2011–2020 at a tertiary care children's hospital were included. Primary outcome was timing of ICH diagnosis on HUS. Seventy-four infants underwent ECLS for cardiac (54%) or pulmonary (46%) indications. Venoarterial ECLS was most common (88%). Median ECLS duration was 6 days (range 1–26). Sixteen patients were diagnosed with ICH (21.6%), at a median of 2 days postcannulation (range 1–4). Nearly all were <4 weeks old at cannulation (93.8%). In conclusion, one-fifth of infants developed ICH diagnosed by HUS while on ECLS, all within the first 4 days of ECLS, consistent with previous literature. Despite advances in critical care and imaging technology, the temporality of ICH diagnosis in infants on ECLS is unchanged.