Modeling of Intracerebral Vascularization After Extracorporeal Membrane Oxygenation in Children
Cerebral Hemodynamic Impact in Children Depending on the Technique of Carotid Artery Decanulation Technique After Extracorporeal Membrane Oxygenation: Modeling of Intra-cerebral Vascular Flows
Assistance Publique - Hôpitaux de Paris
30 participants
Mar 31, 2022
OBSERVATIONAL
Conditions
Summary
Extra corporeal membrane oxygenation (ECMO) is a transient supplementation technique that alleviates hemodynamic and ventilatory failure. Its implementation requires carotid arterial and jugular venous cannulation in newborns or children weighing less than 20 kg. The impact of ECMO on arterial circulation was studied by Doppler ultrasound and shows a redistribution of flows within the circle of Willis. This study aims to model cerebral flow in children who have been cared from jugulocarotid ECMO and compare cerebral hemodynamics according to the technique of reconstruction of the common carotid artery after decanulation (reconstruction or ligation).
Eligibility
Inclusion Criteria11
- For everyone :
- Information and non-opposition of holders of parental authority
- Newborn, infant and child <20kg
- Hospitalization in pediatric and neonatal intensive care unit (PICU) of Trousseau Hospital
- Performing a Magnetic Resonance Angiography (MRA) as part of the treatment
- For patients treated with ECMO: study population
- Hemodynamic or respiratory failure
- Requiring the use of extracorporeal circulation with jugulo-carotid cannulation
- Weaned alive off Extra corporeal membrane oxygenation (ECMO)
- For patients with hypoxic-ischemic encephalopathy: control population
- hypoxic-ischemic encephalopathy diagnosed at birth
Exclusion Criteria2
- Contraindication to MRA
- Opposition of holders of parental authority
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Interventions
Additional acquisition time, time of flight, during brain MRA of the care allowing to obtain the same quality of vascular anatomical visualization as the brain MRA with gadolinium contrast medium injection performed for the care of the patients treated with jugulocarotid ECMO.
The modeling of cerebral vascularization from CRIMSON software (CaRdiovascular Integrated Modeling \& Simulation) requires several inputs: * The MRA images * The cardiac function curve * The cerebral blood flow * Measurement of systolic, diastolic and mean arterial blood pressure
Locations(1)
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NCT05237232