Can clinical parameters help reliably predict the onset of acute intracranial hemorrhage in infants receiving extracorporeal membrane oxygenation?

PURPOSE: To determine whether clinical parameters can be used to help predict the onset of acute intracranial hemorrhage (ICH) in infants receiving extracorporeal membrane oxygenation (ECMO). MATERIALS AND METHODS: The authors retrospectively reviewed cranial sonograms and intensive care unit data for 53 neonates treated with ECMO for intractable cardiorespiratory insufficiency. Thirty-nine boys and 14 girls were treated between February 1988 and June 1993. Gestational age ranged from 34 to 43.5 weeks (mean, 39.2 weeks). Birth weights ranged from 2,200 to 4,650 g (mean, 3,310 g). Multiple clinical variables were subjected to statistical analysis. RESULTS: There were 38 patients without ICH, 10 with early ICH (within 72 hours after cannulation), and five with late ICH (more than 72 hours after cannulation). Analysis with bivariate scatterplots revealed almost complete overlap in the clinical parameters for patients in these three categories. Thus, use of individual variables to predict acute ICH was impractical. CONCLUSION: No clinical parameters helped adequately distinguish patients who developed ICH from those who did not.