ECMO in neonates: neuroimaging findings and outcome

Semin Perinatol. 2014 Mar;38(2):104-13. doi: 10.1053/j.semperi.2013.11.008.


Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for newborns with severe but reversible respiratory failure. Although ECMO has significantly improved survival, it is associated with substantial complications, of which intracranial injuries are the most important. These injuries consist of hemorrhagic and non-hemorrhagic, ischemic lesions. Different from the classical presentation of hemorrhages in preterm infants, hemorrhages in ECMO-treated newborns are mainly parenchymal and with a high percentage in the posterior fossa area. There are conflicting data on the predominant occurrence of cerebral lesions in the right hemisphere. The existence of intracerebral injuries and the classification of its severity are the major predictors of neurodevelopmental outcome. This section will discuss the known data on intracranial injury in the ECMO population and the effect of ECMO on the brain.

Keywords: Brain; Cerebral utrrasound; ECMO; MRI.

Publication types

  • Review

MeSH terms

  • Brain / pathology*
  • Brain Ischemia / complications
  • Brain Ischemia / diagnosis*
  • Brain Ischemia / diagnostic imaging
  • Echoencephalography
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / methods*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / diagnosis*
  • Intracranial Hemorrhages / diagnostic imaging
  • Magnetic Resonance Imaging
  • Respiratory Insufficiency / complications
  • Respiratory Insufficiency / therapy*
  • Treatment Outcome