Papademetriou, MD; Tachtsidis, I; Banaji, M; Elliott, MJ; Hoskote, A; Elwell, CE; (2012) Optical topography to measure variations in regional cerebral oxygenation in an infant supported on veno-arterial extra-corporeal membrane oxygenation. In: Wolf, M and Bucher, HU and Rudin, M and Van Huffel, S and Wolf, U and Bruley, DF and Harrison, DK, (eds.) Oxygen Transport to Tissue XXXIII. (pp. 71 - 76). Springer Verlag: Berlin/ Heidelberg, Germany.

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Abstract

Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for patients with cardio-respiratory failure which exposes the patient to the risk for in-tracranial injury. We used a 12-channel optical topography system to monitor ce-rebral oxygenation in a venoarterial (VA) ECMO patient during alterations in the ECMO flows. Changes in oxy-(HbO2), deoxy-(HHb) and total-(HbT) haemoglo-bin concentrations were measured simultaneously with systemic and ECMO cir-cuit parameters. Decreasing the flows resulted in a decrease in venous (SvO2) and arterial (SpO2) saturations. These were reflected in the haemoglobin data by a sig-nificant increase in HHb of varying magnitude across the 12 channels and mod-erate changes in HbO2 suggestive of cerebral arterial dilation to compensate for the lack of oxygen delivery. In the patient studied here ECMO flows appear to present a significant haemodynamic challenge to cerebral circulation.

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