Brain and ECMO
Background: Canadian children with severe cardiopulmonary failure refractory to conventional intensive care may be treated with extracorporeal membrane oxygenation (ECMO). This technology involves connecting the patient to an artificial pump and membrane lung by inserting cannulas in neck and peripheral vessels (arteries and veins). Between 1 in 40 to 1 in 50 patients admitted to pediatric ICUs are supported with ECMO annually in Canada. Historically, at the time of separation from the technology, vessels were tied-off with the expectation that collateral (and/or contralateral) vessels would suffice to provide adequate blood flow. More recently, to maintain vessel patency surgeons may undertake the reconstruction of vessels. However, there is no information on the impact of the vascular repair on outcomes such as school performance, quality of life or headache symptoms.
Problem: We have shown that being treated with ECMO modifies early and long-term neurologic outcomes (e.g., brain growth or cognitive function). We propose to study the role of vascular repair in patient-reported outcomes to generate scientific evidence that will inform clinical practice and cerebral vascular functional assessments.
We hypothesize that reconstruction may be associated with better patient-reported long-term outcomes compared to ligation. To determine if the approaches have a different impact, we propose to conduct the first multicenter comparative observational study in Canadian youth survivors treated with ECMO between 3 to 10 years ago.
For more information visit the Brain and ECMO study website