Evidence map›Paper›PMID 40244546›Full record

Observational studyNeurocritical care2025

Electroencephalographic Findings Add Prognostic Value to Clinical Features Associated with Mortality on Venoarterial Extracorporeal Support.

Alyson Baker, Ekta Shah, Amy Ouyang, Maya Silver, Stuart R Tomko, Kristin Guilliams, Ahmed S Said, Réjean M Guerriero

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Alyson Baker *Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE, USA.
Ekta Shah *Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, 63110-1093, USA.
Amy OuyangDivision of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, 63110-1093, USA.
Maya SilverDivision of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, 63110-1093, USA.
Stuart R TomkoDivision of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, 63110-1093, USA.
Kristin GuilliamsDivision of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, 63110-1093, USA.
Ahmed S Said *Division of Pediatric Critical Care Medicine, Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA.
Réjean M Guerriero *Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO, 63110-1093, USA. r.guerriero@wustl.edu.ORCID 0000-0001-7788-6661

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe objective of this study was to identify clinical and continuous electroencephalogram (cEEG) variables associated with outcomes of pediatric venoarterial (V-A) extracorporeal membrane oxygenation support (ECMO).

methodsWe conducted a retrospective single-center study of pediatric patients on V-A ECMO between January 1, 2015, and September 30, 2020. Serial clinical and cEEG variables were collected to assess the relationship of pre- and on-ECMO variables with hospital mortality in patients who underwent cEEG monitoring.

resultsNinety-four patients undergoing V-A ECMO had cEEG monitoring, with a hospital mortality of 43%. Nonsurvivors had significantly lower pH and higher lactate levels prior to ECMO initiation. Nineteen (20%) had seizures, with 7 (7%) developing status epilepticus. In the first 24 h patients were on ECMO, unfavorable background score and lack of cEEG variability or reactivity were associated with mortality. A multivariable model investigating in-hospital mortality that included pH and lactate level 2 h prior to ECMO initiation, presence of electrographic seizures, and asymmetry on cEEG as variables, had an area under the receiver operating characteristic curve (AUROC) of 0.8 (95% confidence interval [CI] 0.74-0.86, p < 0.02). The model for on-ECMO mortality (ECMO nonsurvivors) that included pH 2 h prior to ECMO initiation, presence of electrographic seizures, and lack of variability/reactivity at any point on cEEG as variables had an AUROC of 0.85 (95% CI 0.8-0.9, p < 0.001).

conclusionsThese data demonstrate an association of evolving pre-ECMO impaired tissue oxygenation and on-ECMO neurophysiologic impairment, measured by cEEG, with mortality. They provide preliminary evidence that the timing of ECMO initiation, in relation to worsening tissue oxygenation, should be investigated further, and cEEG may be used to evaluate the potential impact on both neurologic injury and mortality.

Indexed as

ElectroencephalographyExtracorporeal Membrane OxygenationHeart FailureHospital MortalityRespiratory InsufficiencyFemaleHumansHydrogen-Ion ConcentrationInfantInfant, NewbornLactic AcidMalePrognosisRetrospective StudiesROC CurveSeizuresLactic AcidElectroencephalographyExtracorporeal membrane oxygenationMortalityPediatrics

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.