title: Regional Cerebral Abnormalities Measured by Frequency-Domain Near-Infrared Spectroscopy in Pediatric Patients During Extracorporeal Membrane Oxygenation.
abstract: Extracorporeal membrane oxygenation (ECMO) is a form of advanced cardiorespiratory support provided to critically ill patients with severe respiratory or cardiovascular failure. While children undergoing ECMO therapy have significant risk for neurological morbidity, currently there is a lack of reliable bedside tool to detect the neurologic events for patients on ECMO. This study assessed the feasibility of frequency-domain near-infrared spectroscopy (NIRS) for detection of intracranial complications during ECMO therapy. The frequency-domain NIRS device measured the absorption coefficient (µa) and reduced scattering coefficient (µs') at six cranial positions from seven pediatric patients (0-16 years) during ECMO support and five healthy controls (2-14 years). Regional abnormalities in both absorption and scattering were identified among ECMO patients. A main finding in this study is that the abnormalities in scattering appear to be associated with lower-than-normal µs' values in regional areas of the brain. Because light scattering originates from the intracellular structures (such as nuclei and mitochondria), a reduction in scattering primarily reflects loss or decreased density of the brain matter. The results from this study indicate a potential to use the frequency-domain NIRS as a safe and complementary technology for detection of intracranial complications during ECMO therapy.
authors.affiliation: From the *Department of Bioengineering, University of Texas at Arlington, Arlington, Texas; †Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; and ‡Children's Health, Dallas, Texas.
authors.forename: Fenghua
authors.initials: F
authors.lastname: Tian
authors.forename: Christopher
authors.initials: C
authors.lastname: Jenks
authors.forename: Donald
authors.initials: D
authors.lastname: Potter
authors.forename: Darryl
authors.initials: D
authors.lastname: Miles
authors.forename: Lakshmi
authors.initials: L
authors.lastname: Raman
mesh_terms: D000293:Adolescent; D001927:Brain Diseases / Q000175:diagnosis*; D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008027:Light; D008297:Male; D012542:Scattering, Radiation; D019265:Spectroscopy, Near-Infrared / Q000379:methods*