Analysis of cerebral hemodynamics in neonates receiving extracorporeal membrane oxygenation support

Abstract Background Cerebral hemodynamic disturbances are common in neonates receiving extracorporeal membrane oxygenation (ECMO), yet systematic data describing changes in cerebral hemodynamics during ECMO support remain limited. This study was conducted to evaluate the changes in cerebral hemodynamics in neonates undergoing ECMO support. Methods This single-center retrospective study included 32 neonates who received ECMO from July 2021 to December 2023 as the ECMO group. Relevant clinical data were collected, including cranial ultrasound examinations before and during ECMO support. Cranial ultrasound data from normal neonates matched for age and sex with the ECMO group were collected as a normal group. Results A total of 32 neonates received ECMO support, among whom 12 (37.5%) developed cerebrovascular complications. After ECMO initiation, the peak systolic velocity (PSV) of the anterior cerebral artery (ACA) increased from 27.8 ± 5.2 cm/s to 43.9 ± 7.5 cm/s, the mean velocity (MV) increased from 15.8 ± 3.6 cm/s to 27.6 ± 3.2 cm/s, and the end-diastolic velocity (EDV) increased from 9.9 ± 3.1 cm/s to 19.6 ± 2.9 cm/s, with all changes reaching statistical significance (P < 0.05). These parameters remained relatively stable during ECMO support but were still lower than the corresponding values observed in the normal control group. Conclusions Cranial ultrasound can serve as an effective tool for assessing cerebral hemodynamics in neonates during ECMO support. Although ECMO significantly improves cerebral perfusion in these patients, their cerebral blood flow velocities during support remain lower than the normal ranges typically observed in healthy neonates.