EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Data Collection
2.3. EEG Measurements
2.4. Neuroimaging Assessments, Scoring and Classification
2.5. Statistical Methods
3. Results
3.1. Patients
3.2. Early Group
3.3. EEG and Neuroimaging Findings
3.4. Medications
3.5. Late Group
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Normal | Mild EEG | Moderate EEG | Severe EEG |
---|---|---|---|
Inconsistent Interhemispheric Asymmetry Mild Focal Abnormalities Mild Disturbance in Background (Paucity of Theta, Excessive Sharp Transients) Mild Excessive Inter Hemispheric Asynchrony Mild Excessive Discontinuity Increase in Number of Frontal Sharp Waves | Excessive Discontinuity of Asynchrony Moderate Persistent Asymmetry of The Background Focal Sharp Waves, Spikes or Delta Activity in Addition to Other Abnormalities Dysmaturity Occasional Positive Rolandic Sharp Waves with Abnormal Background Excessive Diffuse Background Delta Activity with Excessive Discontinuity | Isoelectric Marked Increased Inter Burst Intervals Paroxysmal Background with Or Without Excessive Inter Hemispheric Asynchrony Low Voltage (<20 uV), Diffusely Slow Background Electrographic or Electroclinical Seizures Abundant Positive Rolandic Sharp Waves |
Normal | Mild EEG | Moderate EEG | Severe EEG |
---|---|---|---|
Intermittent Generalized Slowing Continuous Reactive Generalized Slowing Mild/Intermittent Focal Slowing Mild/Intermittent Focal Asymmetry | Continuous Non-Reactive Generalized Slowing Interictal Epileptiform Discharges Lateralized Periodic Discharges Continuous Focal Asymmetry | Electrocerebral Inactivity Burst-Suppression Very Low Voltage Activity (<20 uV) Electrographic or Electroclinical Seizures (Including Status Epilepticus) |
Patient Group, n (%) | Mild EEG, 13 (26%) | Moderate EEG, 17 (34%) | Severe EEG, 20 (40%) |
---|---|---|---|
Age Group, n (%) | |||
Neonates (<44 weeks CGA) | 6 (46%) | 4 (24%) | 8 (40%) |
Children | 7 (54%) | 13 (76%) | 12 (60%) |
Gender, n (%) | |||
Male | 9 (69%) | 12 (71%) | 8 (40%) |
Female | 4 (31%) | 5 (29%) | 12 (60%) |
Primary Diagnosis, n (%) | |||
PPHN | 0 (0%) | 0 (0%) | 1 (5%) |
Sepsis | 0 (0%) | 3 (17.6%) | 1 (5%) |
ARDS | 3 (23%) | 5 (29.4%) | 1 (5%) |
Cardiac | 2 (15.4%) | 1 (5.9%) | 6 (30%) |
ECMO Type, n (%) | |||
Veno-Arterial | 11 (85%) | 9 (53%) | 19 (95%) |
Veno-Venous | 2 (15%) | 8 (47%) | 1 (5%) |
Site of ECMO Cannulation n (%) | |||
Neck | 11 (85%) | 12 (71%) | 16 (80%) |
Femoral | 0 (0%) | 1 (6%) | 0 (0%) |
Central | 2 (15%) | 4 (23%) | 4 (20%) |
Duration of ECMO, h, mean +/− SD | 807.4 +/− 667.5 | 669.3 +/− 398.5 | 230 +/− 180.7 |
Pediatric Risk of Mortality Score (PRISM), Mean +/− SD | 27.6 +/− 5.6 | 30.9 +/− 4.4 | 31.3 +/− 3.7 |
Pediatric Logistic Organ Dysfunction Score (PELOD), mean +/− SD | 15.1 +/− 10.8 | 14.9 +/− 9.3 | 22.6 +/− 16.3 |
Presence of ECMO CPR (eCPR), n (%) | 3 (21.4%) | 4 (28.6%) | 7 (50%) |
Neuroimaging Severity Score, n (%) | |||
Mild | 10 (77%) | 5 (29.5%) | 4 (20%) |
Moderate | 3 (23%) | 5 (29.5%) | 1 (5%) |
Severe | 0 (0%) | 7 (41%) | 15 (75%) |
Survival, n (%) | 9 (69.2%) | 11 (64.7%) | 13 (65%) |
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Fox, J.; Jenks, C.L.; Farhat, A.; Li, X.; Liu, Y.; James, E.; Karasick, S.; Morriss, M.C.; Sirsi, D.; Raman, L. EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation. J. Clin. Med. 2020, 9, 2512. https://doi.org/10.3390/jcm9082512
Fox J, Jenks CL, Farhat A, Li X, Liu Y, James E, Karasick S, Morriss MC, Sirsi D, Raman L. EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation. Journal of Clinical Medicine. 2020; 9(8):2512. https://doi.org/10.3390/jcm9082512
Chicago/Turabian StyleFox, Jordana, Christopher L. Jenks, Abdelaziz Farhat, Xilong Li, Yulun Liu, Ellen James, Stephanie Karasick, Michael C. Morriss, Deepa Sirsi, and Lakshmi Raman. 2020. "EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation" Journal of Clinical Medicine 9, no. 8: 2512. https://doi.org/10.3390/jcm9082512