Cerebral Hemodynamic Impact in Children Depending on the Technique of Carotid Artery Decanulation Technique After Extracorporeal Membrane Oxygenation: Modeling of Intra-cerebral Vascular Flows
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Intracerebral arterial flows of patients treated with ECMO
研究概览
简要总结
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).
详细描述
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.
When ECMO is stopped, carotid decanulation is done either by ligation or by reconstruction, depending on the practices of the surgical team and the peroperative findings. The reconstruction allows a restoration of blood flow to the internal carotid artery and the middle cerebral artery with a disappearance of compensation by the circle of Willis.
Vascular flow modeling is a computational method derived from imaging for the hemodynamic study of fluids, including pressures and flow rates at different points in a vessel. Data from the literature on the modeling of cerebral vascularization in newborns are scarce.
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).
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 年龄范围
- — 至 17 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •Contraindication to MRA
- •Opposition of holders of parental authority
结局指标
主要结局
Intracerebral arterial flows of patients treated with ECMO
时间窗: 1 month
Comparison of intracerebral arterial flows according to the technique of reconstruction of the common carotid artery (reconstruction or ligation) after decanulation from data of MRA performed in weaned living patients off ECMO using computational fluid dynamic.
次要结局
- Modeling of the flow of internal carotid arteries in their extra-cranial portion in children after ECMO(1 month)
- Cerebral vascularization of patients treated for hypoxic-ischemic encephalopathy(1 month)
- Intracerebral arterial flows of patients treated for hypoxic-ischemic encephalopathy(1 month)