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Technique could identify patients at high risk of stroke or brain hemorrhage
Date:6/3/2013

Measuring blood flow in the brain may be an easy, noninvasive way to predict stroke or hemorrhage in children receiving cardiac or respiratory support through a machine called ECMO, according to a new study by researchers at Nationwide Children's Hospital. Early detection would allow physicians to alter treatment and take steps to prevent these complicationsthe leading cause of death for patients on ECMO.

Short for extracorporeal membrane oxygenation, ECMO is used when a patient is unable to sustain enough oxygen in the blood supply due to heart failure, septic shock, or other life-threatening condition, said Nicole O'Brien, MD, a physician and scientist in critical care medicine at Nationwide Children's and lead author of the study, which appears in a recent issue of the journal Pediatric Critical Care Medicine. The patient is connected to ECMO with tubes that carry the patient's blood from a vein through the machine, where it is oxygenated and funneled back to the patient via an artery or vein that then distributes the oxygen-rich blood to vital organs and tissues.

The disease processes that lead someone to need ECMO are different, O'Brien noted, but it is used only after traditional therapies, such as a ventilator, fail. One of the biggest risks of ECMO is bleeding in the brain. Only 36 percent of children who suffer this complication survive, many left with permanent neurologic injury.

"Most of these patients are critically ill before they go on ECMO and often have low oxygen levels, low blood pressure and poor heart function, all of which can certainly lead to strokes," said O'Brien, also an associate professor of clinical medicine at The Ohio State University College of Medicine. "Still, some patients develop problems and others don't and we don't understand why."

To better understand the cause for these brain bleeds, O'Brien launched a pilot study to monitor cerebral blood flow using a transcranial doplar ultras
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Contact: Mary Ellen Peacock
maryellen.peacock@nationwidechildrens.org
614-355-0492
Nationwide Children's Hospital
Source:Eurekalert

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