Resistive index variability in anterior cerebral artery measurements during daily transcranial duplex sonography: A predictor of cerebrovascular complications in infants undergoing extracorporeal membrane oxygenation?

Carlos A. Zamora, Alexander Oshmyansky, Melania Bembea, Ivor David Berkowitz, Eman Alqahtani, Shen Liu, James McGree, Steven Stern, Thierry A G M Huisman, Aylin Tekes

Research output: Contribution to journalArticle

Abstract

Objectives - The purpose of this study was to determine the value of resistive index (RI) variability in predicting cerebrovascular complications during extracorporeal membrane oxygenation (ECMO). Methods - This retrospective study included 36 infants treated by ECMO. The RI was measured on daily transfontanellar duplex sonography, obtained first without fontanel compression and then after gentle compression with the transducer. The age at ECMO cannulation, sex, gestational age at birth, method of delivery, indication, and type and duration of ECMO were recorded. Results - There was a statistically significant difference in RI variability in infants who developed cerebrovascular complications as opposed to those who did not (P = .002). Resistive index variability of 10% or greater on any day was associated with an increased risk for cerebrovascular complications (P = .0482; χ2 = 3.9). Variability in the first 5 days was significantly higher than on following days (P < .0001). The age at ECMO cannulation showed a significant difference, with mean ± SD values of 1.1 ± 0.9 days in the complications group and 2.7 ± 2.2 days in the no-complications group (P = .043). Conclusions - Resistive index variability of 10% or greater on any day had a statistically significant risk of cerebrovascular complication development. Extracorporeal membrane oxygenation cannulation at younger than 3 days conferred an increased risk of cerebrovascular complications.

Original languageEnglish (US)
Pages (from-to)2459-2465
Number of pages7
JournalJournal of Ultrasound in Medicine
Volume35
Issue number11
DOIs
StatePublished - Nov 1 2016

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Anterior Cerebral Artery
Extracorporeal Membrane Oxygenation
Ultrasonography
Catheterization
Transducers
Gestational Age
Retrospective Studies
Parturition

Keywords

  • Autoregulation
  • Duplex head sonography
  • Extracorporeal membrane oxygenation
  • Infants
  • Pediatric ultrasound
  • Resistive index

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Resistive index variability in anterior cerebral artery measurements during daily transcranial duplex sonography : A predictor of cerebrovascular complications in infants undergoing extracorporeal membrane oxygenation? / Zamora, Carlos A.; Oshmyansky, Alexander; Bembea, Melania; Berkowitz, Ivor David; Alqahtani, Eman; Liu, Shen; McGree, James; Stern, Steven; Huisman, Thierry A G M; Tekes, Aylin.

In: Journal of Ultrasound in Medicine, Vol. 35, No. 11, 01.11.2016, p. 2459-2465.

Research output: Contribution to journalArticle

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abstract = "Objectives - The purpose of this study was to determine the value of resistive index (RI) variability in predicting cerebrovascular complications during extracorporeal membrane oxygenation (ECMO). Methods - This retrospective study included 36 infants treated by ECMO. The RI was measured on daily transfontanellar duplex sonography, obtained first without fontanel compression and then after gentle compression with the transducer. The age at ECMO cannulation, sex, gestational age at birth, method of delivery, indication, and type and duration of ECMO were recorded. Results - There was a statistically significant difference in RI variability in infants who developed cerebrovascular complications as opposed to those who did not (P = .002). Resistive index variability of 10{\%} or greater on any day was associated with an increased risk for cerebrovascular complications (P = .0482; χ2 = 3.9). Variability in the first 5 days was significantly higher than on following days (P < .0001). The age at ECMO cannulation showed a significant difference, with mean ± SD values of 1.1 ± 0.9 days in the complications group and 2.7 ± 2.2 days in the no-complications group (P = .043). Conclusions - Resistive index variability of 10{\%} or greater on any day had a statistically significant risk of cerebrovascular complication development. Extracorporeal membrane oxygenation cannulation at younger than 3 days conferred an increased risk of cerebrovascular complications.",
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AU - Oshmyansky, Alexander

AU - Bembea, Melania

AU - Berkowitz, Ivor David

AU - Alqahtani, Eman

AU - Liu, Shen

AU - McGree, James

AU - Stern, Steven

AU - Huisman, Thierry A G M

AU - Tekes, Aylin

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AB - Objectives - The purpose of this study was to determine the value of resistive index (RI) variability in predicting cerebrovascular complications during extracorporeal membrane oxygenation (ECMO). Methods - This retrospective study included 36 infants treated by ECMO. The RI was measured on daily transfontanellar duplex sonography, obtained first without fontanel compression and then after gentle compression with the transducer. The age at ECMO cannulation, sex, gestational age at birth, method of delivery, indication, and type and duration of ECMO were recorded. Results - There was a statistically significant difference in RI variability in infants who developed cerebrovascular complications as opposed to those who did not (P = .002). Resistive index variability of 10% or greater on any day was associated with an increased risk for cerebrovascular complications (P = .0482; χ2 = 3.9). Variability in the first 5 days was significantly higher than on following days (P < .0001). The age at ECMO cannulation showed a significant difference, with mean ± SD values of 1.1 ± 0.9 days in the complications group and 2.7 ± 2.2 days in the no-complications group (P = .043). Conclusions - Resistive index variability of 10% or greater on any day had a statistically significant risk of cerebrovascular complication development. Extracorporeal membrane oxygenation cannulation at younger than 3 days conferred an increased risk of cerebrovascular complications.

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