Evidence map›Paper›PMID 42192048›Full record

ArticleNeurocritical care2026

Neuroimaging and Neuropathologic Findings in Pediatric Patients with ECMO: An Imaging-Pathology Comparison.

Margherita Tabet, Bill Zhang, Chasity Custer, Michael Craig Morriss, Sumit Singh, Aliya Abioye, Priscilla Yu, Ethan Sanford, Lakshmi Raman, Veena Rajaram and 1 more

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Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Margherita TabetDepartment of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX, USA. margherita.tabet@utsouthwestern.edu.ORCID http://orcid.org/0000-0003-0595-8480
Bill ZhangDepartment of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX, USA.
Chasity CusterDivision of Pediatric Critical Care Medicine, UT Southwestern Medical Center/Children's Health, Dallas, TX, USA.
Michael Craig MorrissDepartment of Radiology, UT Southwestern Medical Center/Children's Health, Dallas, TX, USA.
Sumit SinghDepartment of Radiology, UT Southwestern Medical Center/Children's Health, Dallas, TX, USA.
Aliya AbioyeDepartment of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX, USA.
Priscilla YuDivision of Pediatric Cardiology, UT Southwestern Medical Center/Children's Health, Dallas, TX, USA.
Ethan SanfordDepartment of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX, USA.
Lakshmi RamanDivision of Pediatric Critical Care Medicine, UT Southwestern Medical Center/Children's Health, Dallas, TX, USA.
Veena Rajaram *Department of Pathology, UT Southwestern Medical Center/Children's Health, Dallas, TX, USA.
David R Busch *Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, Dallas, TX, USA.

Funding

Development of quantitative optical tools to continuously monitor cerebral autoregulation, blood flow, oxygenation and inflammation during pediatric extracorporeal life supportR01NS122119 · NINDS · UT SOUTHWESTERN MEDICAL CENTER · PI David Richard Busch · 2022 to 2026
$3.2M
NIH NINDS R01NS122119
6 · The paper itself

Abstract

objectiveNeurologic complications are a leading cause of morbidity and mortality in children supported with extracorporeal membrane oxygenation (ECMO). Antemortem neuroimaging is limited, while postmortem neuropathology provides definitive but rarely available assessment. Correlating imaging with pathology may improve diagnostic accuracy and monitoring strategies.

designWe performed a retrospective, single-center cohort study of neonates and children (0-18 years) supported with ECMO (2009-2024) who underwent cerebral autopsy. Standardized neuropathologic sampling across six brain regions classified injuries as mild, moderate, or severe. Antemortem imaging (computed tomography [CT] or head ultrasound [HUS]) within 7 days of death was reviewed by a blinded neuroradiologist and scored using a Neurologic Injury Severity (NIS) framework. Imaging-pathology correlation was assessed in patients with both datasets. MEASUREMENTS AND MAIN

resultsA total of 54 patients underwent neuropathologic evaluation; 26 had qualifying neuroimaging. Neuropathology revealed frequent ischemic and hemorrhagic injuries, most commonly in the frontal lobes, deep grey matter, and temporal lobes. Severe injury was more frequent in venoarterial ECMO and in infants/toddlers. NIS scores strongly correlated with global and regional histopathologic severity, particularly in frontal, temporal, and deep grey regions. Discordance was observed in parieto-occipital, pontine, and cerebellar regions, where immunohistochemistry (GFAP, CD68) detected subtle injuries not visible with hematoxylin and eosin (H&E). Severe pathology consistently corresponded to NIS ≥ 10, while mild pathology aligned with low scores and limited involvement.

conclusionsStructured imaging severity scoring, especially with CT, correlates strongly with neuropathology in pediatric decedents of ECMO. Findings support NIS scoring as a surrogate for underlying pathology, while underscoring the need for refined histologic methods and adjunctive neuromonitoring to optimize neurologic surveillance.

Indexed as

Brain injuriesCritical careExtracorporeal membrane oxygenationNeurodiagnostic techniquesNeuroimagingNeuropathologyPediatrics

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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 Socratic graph.