Symmetric Cerebral Blood Flow in Newborns Who Have Undergone Successful Extracorporeal Membrane Oxygenation

Abstract

Cerebral blood flow (CBF) was measured with positron emission tomography in 23 newborns following extracorporeal membrane oxygenation. In 9 newborns the common carotid artery was reanastomosed after extracorporeal membrane oxygenation and in 14 newborns the common carotid artery remained ligated. The ratio of right/left hemispheric CBF was not significantly different in the newborns with reanastomosed or occluded common carotid arteries (right/left CBF ratio was 0.98 in both groups). The maximum asymmetry was 8% and was observed in 2 newborns. All 9 newborns with reanastomosis of the carotid artery are normal at follow-up at 1 year or longer. Three newborns with ligation of the common carotid artery were lost to follow-up and 1 newborn died. Eight of 10 remaining newborns are normal at follow-up; the 2 other infants have developmental quotients of 60 and 64, respectively, and no other deficits. The data indicate (1) that hemispheric CBF is symmetric in newborns who have undergone extracorporeal membrane oxygenation and have no evidence of brain injury, and (2) that reanastomosis of the common carotid artery does not alter hemispheric CBF in the newborn period.