TY - JOUR
T1 - Resistive index variability in anterior cerebral artery measurements during daily transcranial duplex sonography
T2 - A predictor of cerebrovascular complications in infants undergoing extracorporeal membrane oxygenation?
AU - Zamora, Carlos A.
AU - Oshmyansky, Alexander
AU - Bembea, Melania
AU - Berkowitz, Ivor
AU - Alqahtani, Eman
AU - Liu, Shen
AU - McGree, James
AU - Stern, Steven
AU - Huisman, Thierry A.G.M.
AU - Tekes, Aylin
N1 - Publisher Copyright:
© 2016 by the American Institute of Ultrasound in Medicine.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - 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.
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.
KW - Autoregulation
KW - Duplex head sonography
KW - Extracorporeal membrane oxygenation
KW - Infants
KW - Pediatric ultrasound
KW - Resistive index
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U2 - 10.7863/ultra.15.09046
DO - 10.7863/ultra.15.09046
M3 - Article
C2 - 27698183
AN - SCOPUS:84994012287
SN - 0278-4297
VL - 35
SP - 2459
EP - 2465
JO - Journal of Ultrasound in Medicine
JF - Journal of Ultrasound in Medicine
IS - 11
ER -