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Clinical Guidelines for Routine Neuromonitoring in Neonatal and Pediatric Patients Supported on Extracorporeal
Poornima Pandiyan1, Mirjana Cvetkovic2, Marta Velia Antonini3,4
1From the Department of Pediatrics, Division of Medical Critical Care, Boston Children's Hospital, Tufts University School of Medicine, Boston, Massachusetts.
Insights
These guidelines offer educational support for neuromonitoring in neonatal and pediatric patients on extracorporeal membrane oxygenation (ECMO). They aim to aid clinicians in assessing and managing patients during extracorporeal life support (ECLS).
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Neonatology
Background:
- Extracorporeal membrane oxygenation (ECMO) is a life-support technology for critically ill neonates and children.
- Neuromonitoring is crucial for assessing neurological status in these vulnerable patients.
- Existing guidelines for neuromonitoring during ECMO are limited, necessitating educational resources for healthcare professionals.
Purpose of the Study:
- To provide educational guidelines for routine neuromonitoring in neonatal and pediatric patients undergoing ECMO.
- To enhance the knowledge of physicians and health professionals in assessing and managing patients on ECMO.
- To describe practices considered useful and safe for patients on extracorporeal life support (ECLS)/ECMO.
Main Methods:
- Development of guidelines based on current knowledge and expert opinion.
- Focus on educational use for healthcare professionals involved in ECMO care.
- Description of practices for neuromonitoring in pediatric and neonatal ECMO patients.
Main Results:
- The guidelines offer a framework for neuromonitoring in pediatric and neonatal ECMO patients.
- They aim to assist clinicians in making informed decisions regarding patient care.
- The guidelines describe practices believed to be useful and safe, though not necessarily consensus recommendations.
Conclusions:
- These guidelines serve as an educational tool to improve neuromonitoring practices in ECMO.
- Clinical judgment and case-by-case decision-making remain paramount.
- Adherence to guidelines does not guarantee outcomes; individual patient circumstances must guide treatment.
Disclaimer:
These guidelines for routine neuromonitoring in neonatal and pediatric patients supported on extracorporeal membrane oxygenation (ECMO) are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing extracorporeal life support (ECLS)/ECMO and describe what are believed to be useful and safe practice for ECLS and ECMO but these are not necessarily consensus recommendations. The aim of clinical guidelines was to help clinicians to make informed decisions about their patients. However, adherence to a guideline does not guarantee a successful outcome. Healthcare professionals must make their own treatment decisions about care on a case-by-case basis, after consultation with their patients, using their clinical judgment, knowledge, and expertise. These guidelines do not take the place of physicians' and other health professionals' judgment in diagnosing and treatment of patients. These guidelines are not intended to and should not be interpreted as setting a standard of care or being deemed inclusive of all proper methods of care nor exclusive of other methods of care directed at obtaining the same results. The ultimate judgment must be made by the physician and other health professionals and the patient considering all the circumstances presented by the individual patient, and the known variability and biologic behavior of the clinical condition. These guidelines reflect the data at the time the guidelines were prepared; the results of subsequent studies or other information may cause revisions to the recommendations in these guidelines to be prudent to reflect new data, but ELSO is under no obligation to provide updates. In no event will ELSO be liable for any decision made or action taken in reliance upon the information provided through these guidelines.
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