Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar;36(3):230-236.
doi: 10.1177/0883073820966917. Epub 2020 Oct 28.

Seizures Are Associated With Brain Injury in Infants Undergoing Extracorporeal Membrane Oxygenation

Sarah L Bauer Huang  1 , Ahmed S Said  2 , Christopher D Smyser  1   3 , John C Lin  2 , Kristin P Guilliams  1   2 , Réjean M Guerriero  1
Affiliations

Seizures Are Associated With Brain Injury in Infants Undergoing Extracorporeal Membrane Oxygenation

Sarah L Bauer Huang et al. J Child Neurol. 2021 Mar.

Abstract

Objective: Determine seizure frequency and association with neurologic outcomes in infants undergoing extracorporeal membrane oxygenation. Identify patient or clinical factors associated with seizures or brain injury on imaging.

Methods: Retrospective, single-center study including infants less than 1 year of age, who underwent extracorporeal membrane oxygenation between 2012 and 2017.

Results: A total of 104 infants met study criteria including 45 patients with continuous electroencephalographic (EEG) monitoring during their extracorporeal membrane oxygenation run and 59 infants without EEG. Seizures (electrographic-only or electro-clinical) were identified in 18 of the 45 (40%). Among the 18 infants with seizures, 14 (78%) had moderate to severe brain injury, whereas only 44% of those without seizures (12 of 27) on EEG had moderate to severe brain injury (P = .03). Cardiopulmonary resuscitation prior to extracorporeal membrane oxygenation (ECPR), mode of extracorporeal membrane oxygenation, length of stay, survival to discharge, and congenital heart disease were not associated with seizures. One of 10 patients with cyanotic congenital heart disease due to hypoplastic left heart syndrome had seizures compared with 7 of 10 patients with non-hypoplastic left heart syndrome lesions (P = .02). Seizures were associated with moderate to severe brain injury, after adjusting for ECPR and congenital heart disease (P = .04).

Conclusions: Electrographic seizures were common in patients undergoing extracorporeal membrane oxygenation and higher than previously reported. Seizures were associated with moderate to severe abnormalities on imaging, after adjusting for ECPR and congenital heart disease. This study adds to recent literature describing the risk of seizures in patients on extracorporeal membrane oxygenation and highlights the presence of brain injuries that may be identified by routine EEG surveillance.

Keywords: congenital heart disease; electroencephalography; extracorporeal membrane oxygenation; neonatal; neurologic outcomes.

PubMed Disclaimer

Figures

Figure 1:
Figure 1:
Patient identification
Figure 2a:
Figure 2a:
In patients with CHD, electrographic seizures are more likely to be associated with cyanotic non-HLHS lesions. 2b: Electrographic seizures are associated with moderate to severe brain imaging findings. CHD: congenital heart disease HLHS: Hypoplastic left heart syndrome
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. https://www.elso.org/Registry/Statistics/InternationalSummary.aspx. Updated January 2020. Accessed March 31, 2020.
    1. Boyle K, Felling R, Yiu A, et al. Neurologic Outcomes After Extracorporeal Membrane Oxygenation: A Systematic Review. Pediatr Crit Care Med. 2018;19(8):760–766. - PMC - PubMed
    1. von Bahr V, Kalzen H, Hultman J, et al. Long-Term Cognitive Outcome and Brain Imaging in Adults After Extracorporeal Membrane Oxygenation. Crit Care Med. 2018;46(5):e351–e358. - PubMed
    1. Wien MA, Whitehead MT, Bulas D, et al. Patterns of Brain Injury in Newborns Treated with Extracorporeal Membrane Oxygenation. AJNR Am J Neuroradiol. 2017;38(4):820–826. - PMC - PubMed
    1. Carpenter JL, Yu YR, Cass DL, et al. Use of venovenous ECMO for neonatal and pediatric ECMO: a decade of experience at a tertiary children’s hospital. Pediatr Surg Int. 2018;34(3):263–268. - PubMed

Publication types