Article Figures & Data
Figures
- Fig 1.
Flowchart of subject inclusion.
- Fig 2.
A, Coronal T2-weighted image demonstrates ventriculomegaly, scored as grade 2 on our scale; B, Coronal T2-weighted image demonstrates enlarged extra-axial spaces, scored as grade 2 on our scale. C, SWI shows evidence of grade 2 intraventricluar hemorrhage (arrows). D, SWI shows evidence of parenchymal hemorrhage, grade 1 on our scale (arrow). E, SWI shows foci of cerebellar hemorrhage, grade 2 on our scale (arrows). F, Axial T1 weighted images demonstrate foci of bilateral white matter injury, grade 2 on our scale (arrows).
- Fig 3.
Boxplots of the distribution of the brain injury score in infants with CDH with ECMO and those without it. The central thick line in each box is the median score. The limits of the box indicate upper and lower quartiles. The whisker limits indicate the highest or lowest score, not considering outliers. There is 1 outlier with a higher brain injury score in the non-ECMO group with a score of >1.5 interquartile range above the upper quartile. This infant had a CDH defect D.
- Fig 4.
Enlarged extra-axial spaces versus head circumference, plotted on Fenton head circumference charts.13
Tables
MRI Findings vs Score 0 1 2 3 4 Ventriculomegaly <10 mm 10–15 mm >15 mm Obstructive Extra-axial spaces <5 mm 5–10 mm >10 mm Intraventricular hemorrhage None Grade 1 Grade 2 Grade 3 Grade 4 Parenchymal hemorrhage (not grade 4 intraventricular hemorrhage) Absent Present Cerebellar hemorrhage None <3 foci, <5-mm size >3 foci or >5-mm size White matter injury None <3 foci, unilateral >3 foci or bilateral Multiregional Cortical injury None Single Multiple Extensive Basal ganglia injury None Single Multiple Extensive Total Infants in the Study (N = 53) Male (%) 31 (58%) Gestational age at birth (wk)a 38 (32.9–40.6) Birth weight (g)a 2960 (1430–4175) Diaphragmatic defect A 8 (15%) B 16 (30%) C 22 (42%) D 7 (13%) Days on ventilatora 27 (8–88) Length of stay (day)a 60 (15–210) Age at repair (wk)a 9 (1–54) Required inotropic support (%) 35 (66%) Required ECMO (%) 9 (17%) Required O2 at 28 days of life (%) 37 (70%) Any oral feeding at discharge (%) 40 (75%) ↵a Data are expressed as median (range).
- Table 3:
Differences in the presence of brain injury between infants with and without ECMO
ECMO (n = 9) No ECMO (n = 44) P Valuea Ventriculomegaly 5 (56%) 8 (18%) .03 Extra-axial spaces 8 (89%) 11 (25%) <.0001 Intraventricular hemorrhage 4 (44%) 8 (18%) .18 Parenchymal hemorrhage 3 (33%) 1 (2%) .013 Cerebellar hemorrhage 3 (33%) 6 (14%) .17 White matter injury 4 (44%) 5 (11%) .035 Cortical injury 1 (11%) 1 (2%) .31 Basal ganglia injury 1 (11%) 0 .17 ↵a Calculated using the Fisher exact test.
Any Injury (n = 32) No Injury (n = 21) P Value Any oral feeding at discharge 21 (65.6%) 19 (90.5%) .04 Requirement for NG feeding at discharge 9 (28.1%) 10 (47.6%) .15 G-tube placement before discharge 13 (40.6%) 4 (19.1%) .10 No inotropes 9 (28.1%) 9 (42.9%) .27 Blood stream infectiona 3 (9.4% 0 .27b Lung infection 7 (22.6%) 2 (9.5%) .28b Required ECMOa 9 (28.1%) 0 .008b Diaphragmatic defect .01 A or B 10 (31.3%) 14 (66.7%) C or D 22 (68.8%) 7 (33.3%)
