Morbidity for Survivors of Extracorporeal Membrane Oxygenation: Neurodevelopmental Outcome at 1 Year of Age

PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. 72-78
Author(s):  
Penny Glass ◽  
Marilea Miller ◽  
Billie Short
Keyword(s):  
High Risk ◽  
Carotid Artery ◽  
Extracorporeal Membrane Oxygenation ◽  
Jugular Vein ◽  
Long Term Outcome ◽  
Membrane Oxygenation ◽  
Cardiopulmonary Support ◽  
High Risk Infants ◽  
The Right

Extracorporeal membrane oxygenation is an important technology in the treatment of high-risk infants whose long-term outcome is being followed prospectively at our institution. The extracorporeal membrane oxygenation procedure allows temporary cardiopulmonary support for critically ill full-term neonates who are refractory to maximum ventilatory and medical management as a consequence of severe persistent pulmonary hypertension. The technique necessitates both the permanent ligation of the right common carotid artery and jugular vein and systemic heparinization. The survivors constitute a unique group of high-risk infants, from the standpoint of the hypoxic-ischemic insults preceding extracorporeal membrane oxygenation and the risks associated with the procedure. Our results indicate that most of our survivors are developing normally at 1 year. Major morbidity, in terms of either significant developmental delay (Bayley mental and motor indices less than 70) or significant neuromotor abnormality, occurred in only 10% of these infants. Poor outcome was associated with major intracranial hemorrhage and chronic lung disease. Ligation of the right carotid artery and jugular vein was not associated with a consistent lateralizing lesion. Long-term follow-up through school age is essential.

Long-term outcome following extracorporeal membrane oxygenation for congenital diaphragmatic hernia: the UK experience

2004 ◽  
Vol 144 (3) ◽  
pp. 309-315 ◽  
Author(s):  
Peter J Davis ◽  
Richard K Firmin ◽  
Brad Manktelow ◽  
Allan P Goldman ◽  
Carl F Davis ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Membrane Oxygenation ◽  
The Uk

THE STUDY OF OVARIAN FUNCTION IN THE EWE BY MEANS OF A VASCULAR AUTOTRANSPLANTATION TECHNIQUE

1967 ◽  
Vol 39 (1) ◽  
pp. 37-NP ◽  
Author(s):  
J. R. GODING ◽  
J. A. McCRACKEN ◽  
D. T. BAIRD
Keyword(s):  
Carotid Artery ◽  
Ovarian Function ◽  
Jugular Vein ◽  
Venous Drainage ◽  
Second Stage ◽  
The Right ◽  
To Receive ◽  
Behavioural Evidence

SUMMARY In order to obtain exclusive long-term access to both the arterial and venous sides of the ovarian circulation in the ewe, a technique was evolved for vascular autotransplantation of the ovary. The first stage consisted of the preparation of a carotid artery—jugular vein skin tube, with a pouch to receive the ovary and its pedicle. In the second stage, performed at least 2 months later, the left ovary and its pedicle were removed together with an aortic patch which included the orifice of the ovarian artery. The aortic patch was inlaid into the carotid artery to provide the arterial supply to the transplanted ovary; venous drainage was achieved by end-to-side anastomosis of the termination of the middle uterine vein to the jugular vein. The right ovary was removed. The transplanted ovary was shown to have an unimpaired circulation. Ovarian function was demonstrated by histological and behavioural evidence, and by demonstration of a cyclical secretion of progesterone. The rate of progesterone secretion was < 5 μg./hr. at oestrus and rose to approximately 200 μg./hr. in the luteal phase of the cycle which is within the range reported for the ovary in situ.

Cerebrovascular moyamoya disease in a 5-year-old girl who underwent interruption of the right common carotid artery in the neonatal period

2009 ◽  
Vol 3 (4) ◽  
pp. 316-319 ◽  
Author(s):  
Yoshihiko Maeda ◽  
Sadahiro Nomura ◽  
Tetsu Kurokawa ◽  
Hideyuki Ishihara ◽  
Kei Harada ◽  
...  
Keyword(s):  
Cerebral Ischemia ◽  
Carotid Artery ◽  
Extracorporeal Membrane Oxygenation ◽  
Moyamoya Disease ◽  
Common Carotid Artery ◽  
Neonatal Period ◽  
Membrane Oxygenation ◽  
Moyamoya Vessel ◽  
The Right ◽  
The Brain

The authors report on the case of a girl with cerebrovascular moyamoya disease born with severe respiratory failure caused by a congenital diaphragmatic hernia. Cardiopulmonary management included extracorporeal membrane oxygenation until the diaphragm defect was repaired. The right common carotid artery (CA) was interrupted and cannulated for extracorporeal membrane oxygenation. When she was 5 years of age, the patient experienced ischemic symptoms in her right extremities. Angiography revealed stenosis of the terminal portion of the internal CA (ICA) with the development of moyamoya vessels on the left side of the brain; the right ICA was supplied by extracranial anastomotic arteries. Indirect extracranial–intracranial bypass surgery was performed in the left hemisphere, and the hypoperfusion improved. The same change in the intracranial ICA with the development of moyamoya vessels occurred on her right side when she was 7 years old. Decreased cerebral blood flow occurred twice, and the moyamoya vessels developed to compensate for the cerebral ischemia. However, the occlusion of the extracranial common CA in infancy induced extracranial anastomosis rather than moyamoya vessel proliferation, and collateral circulation was formed at the lesion site. This finding indicates that neoangiogenesis requires both cerebral ischemia and growth factors derived from the lesion.

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