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.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|August 21, 2023
PubMed

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.
Abstract

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