Decreased incidence of intracranial hemorrhage using cephalic jugular venous drainage during neonatal extracorporeal membrane oxygenation.
Intracranial hemorrhage (ICH) remains one of the more common serious complications of extracorporeal membrane oxygenation (ECMO) in neonates. In 1990 this center began routine use of cephalic jugular venous drainage during neonatal ECMO to augment blood return to the ECMO pump and potentially decrease the incidence of ICH by decreasing cerebral venous pressure. Thirty-four ECMO cases utilizing cephalic jugular venous drainage were compared with the previous 34 ECMO cases. The incidence of ICH decreased from 35% (12/34) to 6% (2/34) when neonates without cephalic jugular venous drainage are compared with those being subject to this technique (P < .01). No differences were found between the two groups in gestational age, birth weight, duration of ECMO, survival, platelet counts, activated clotting times, or incidence of other bleeding complications. Cephalic jugular venous drainage during neonatal ECMO appears to be safe and may decrease the incidence of ICH.
O'Connor
T A
TA
Sections of Neonatology, Children's Mercy Hospital, Kansas City, MO.
Haney
B M
BM
Grist
G E
GE
Egelhoff
J C
JC
Snyder
C L
CL
Ashcraft
K W
KW
D002405:Catheterization, Central Venous / Q000295:instrumentation / Q000379:methods; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D016009:Chi-Square Distribution; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007601:Jugular Veins; D008923:Missouri / Q000453:epidemiology