The focus of the Imaging Research Initiative is to advance the use of imaging technology in the study of pediatric diseases in the laboratory and in clinical practice. This year we were honored to receive a commitment from the Associates and Affiliates to raise $2 million to build an endowment in support of our research efforts in imaging research and the development of our core facilities in imaging.
The imaging research program has two main goals:
Skorn Ponrartana, MD, MPH, focuses on imaging children from the fetal period to early childhood to identify potential pediatric biomarkers that predict later disease in life. Specifically, he is using nonionizing MRI to safely examine placental morphology and the development of fetal characteristics through birth and infancy. The early identification of disease markers may serve as a way to predict the later development of pervasive public health conditions, such as cardiovascular disease and diabetes.
Long-Term Effects of ECMO
At the same time, the first babies who needed this extraordinary method of life support are now growing older—there are nearly 12,000 survivors of Veno-Arterial (VA) ECMO in the United States alone. In this procedure, the right carotid artery, which supplies oxygen to the developing brain, is tied off and the ECMO technology takes over. The left carotid artery is intact and able to provide sufficient blood flow.
Using high-resolution ultrasonography to measure the carotid arterial wall, the investigators found a significant increase in the thickening of the wall in the ECMO survivors compared with 31 healthy subjects. While the difference was not alarming, and most ECMO patients are doing well, Dr. Friedlich says long-term studies are needed to better understand the lifelong impact on cardiovascular health. This collaborative study is in keeping with the spirit of ECMO itself—a technology made possible by the combined talents of neonatologists, pediatric surgeons, radiologists and specially trained nurses.
In 2007, Philippe S. Friedlich, MD, medical director of the Neonatal and Infant Critical Care Unit in the Center for Fetal and Neonatal Medicine at Childrens Hospital, and Vicente Gilsanz, MD, PhD, launched the first study of the impact of living with one carotid artery after ECMO use. Thirty-one former VA ECMO patients from Childrens Hospital, now 12 to 20 years old, participated.