EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation

Jordana Fox; Christopher L Jenks; Abdelaziz Farhat; Xilong Li; Yulun Liu; Ellen James; Stephanie Karasick; Michael C Morriss; Deepa Sirsi; Lakshmi Raman

doi:10.3390/jcm9082512

EEG is A Predictor of Neuroimaging Abnormalities in Pediatric Extracorporeal Membrane Oxygenation

J Clin Med. 2020 Aug 4;9(8):2512. doi: 10.3390/jcm9082512.

Authors

Jordana Fox¹, Christopher L Jenks², Abdelaziz Farhat^{3

4}, Xilong Li⁵, Yulun Liu⁵, Ellen James⁴, Stephanie Karasick⁴, Michael C Morriss^{4

6}, Deepa Sirsi^{3

4

7}, Lakshmi Raman^{3

4}

Affiliations

¹ Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ 85016, USA.
² Department of Pediatrics University of Mississippi, Oxford, MS 38677, USA.
³ Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Dallas, TX 75390, USA.
⁴ Children's Medical Center of Dallas, Dallas, TX 75235, USA.
⁵ Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
⁶ Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
⁷ Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.

Abstract

The goal of this project was to evaluate if severity of electroencephalogram (EEG) during or shortly after being placed on extracorporeal membrane oxygenation (ECMO) would correlate with neuroimaging abnormalities, and if that could be used as an early indicator of neurologic injury. This was a retrospective chart review spanning November 2009 to May 2018. Patients who had an EEG recording during ECMO or within 48 hours after being decannulated (early group) or within 3 months of being on ECMO (late group) were included if they also had ECMO-related neuroimaging. In the early EEG group, severity of the EEG findings of mild, moderate, and severe EEG correlated to mild, moderate, and severe neuroimaging scores. Patients on venoarterial (VA) ECMO were noted to have higher EEG and neuroimaging severity; this was statistically significant. There was no association in the late EEG group to neuroimaging abnormalities. Our study highlights that EEG severity can be an early predictor for neuroimaging abnormalities that can be identified by computed tomography (CT) and or magnetic resonance imaging (MRI). This can provide guidance for both the medical team and families, allowing for a better understanding of overall prognosis.

Keywords: electroencephalogram (EEG); extracorporeal membrane oxygenation (ECMO); neuroimaging; seizures.