Document Detail


Neonatal cerebral oximetry monitoring during ECMO cannulation.
MedLine Citation:
PMID:  19158806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Neonates were monitored with a cerebral oximeter before, during, and after cannulation for ECMO to determine the direct effects of ligation of the right internal jugular vein and right carotid artery on cerebral oxygenation. STUDY DESIGN: After obtaining informed consent, we used the FORE-SIGHT Cerebral Oximeter (CAS Medical Systems, Branford, CT, USA) to monitor neonates undergoing surgical preparation for veno-arterial (VA) or veno-venous (VV) extracorporeal membrane oxygenation (ECMO). RESULT: A total of 17 subjects were monitored pre-ECMO for at least 48 h after cannulation. Of the 17 subjects, 12 experienced low cerebral tissue oxygen saturation (SctO(2)) <60% during pre-ECMO surgery, with most exhibiting the lowest SctO(2) values between cannulation to the onset of ECMO. Two subjects received cardiopulmonary resuscitation (CPR) during surgery and experienced very low SctO(2) (5 and 36%). Pulse oximetry was found to be unreliable during CPR because of diminished pulsatile flow. SctO(2) increased above 60% after the onset of ECMO for all subjects and remained stable. CONCLUSION: Neonates are vulnerable to SctO(2) during the pre-ECMO surgical period.
Authors:
J C Fenik; K Rais-Bahrami
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-01-22
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  29     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-28     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-81     Citation Subset:  IM    
Affiliation:
Department of Neonatology, Children's National Medical Center, Washington, DC 20010, USA.
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MeSH Terms
Descriptor/Qualifier:
Brain / blood supply*
Catheterization, Central Venous
Cerebrovascular Circulation / physiology
Extracorporeal Membrane Oxygenation / methods*
Female
Follow-Up Studies
Humans
Infant, Newborn
Male
Monitoring, Physiologic
Oximetry / methods*
Oxygen Consumption / physiology
Probability
Respiratory Distress Syndrome, Newborn / diagnosis,  mortality,  therapy*
Risk Assessment
Sampling Studies
Sensitivity and Specificity
Statistics, Nonparametric
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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