A WAY TO ASSESS THE IMPAIRMENT OF CEREBRAL AUTOREGULATION IN PEDIATRIC PATIENTS UNDER ECMO WITH NEUROIMAGING ABNORMALITIES

Abstract

Cerebral autoregulation protects the healthy brain by maintaining an adequate cerebral blood flow in case of blood pressure changes. Cannulation of great blood vessels and alterations of pulsatile flow patterns during ECMO (Extracorporeal membrane oxygenation) alters cerebral autoregulation. This project provides a reliable methodology that can assess the degree of cerebral autoregulation impairment of ECMO patients and examine if it can be correlated or predictive of neuroimaging abnormalities. Initially, we used the normal WTC MATLAB code to obtain a time-frequency map. Then we calculated the in-phase percent significance and used the resultant values to determine the Scale Averaged Percent Significance of Coherence (SASC) specifically in ranges 0-2.5-hour scale. The results showed that the lower the new SASC (as a Cerebral Autoregulation index), the better the brain is. Comparing SASC to the MRI consensus, the average autoregulation index is >10% which is consistent with the ECMO outcome indicating mild neurological injury, meaning SASC can be predicative for ECMO patients. WTC during the total ECMO duration would show a clearer correlation with clinical outcome, thus further studies are needed to analyze that along with taking more patients into consideration (in addition to the current fourteen).