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Updated: Jun 6, 2025
03:40
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
259
Neurological Monitoring and Management for Adult Extracorporeal Membrane Oxygenation Patients: Extracorporeal Life
Sung-Min Cho1,2, Jaeho Hwang1, Giovanni Chiarini3,4
1Divisions of Neuroscience Critical Care and Cardiac Surgery Departments of Neurology, Neurosurgery, and Anaesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 455, 21287, Baltimore, MD, USA.
ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 2, 2024
Summary
Guidelines for neurological care in extracorporeal membrane oxygenation (ECMO) patients with acute brain injury (ABI) are established. These recommendations address monitoring, management, and prognostication to improve outcomes for critically ill adults.
Area of Science:
- Critical Care Medicine
- Neurocritical Care
- Extracorporeal Life Support
Background:
- High-quality clinical evidence for managing acute brain injury (ABI) in extracorporeal membrane oxygenation (ECMO) patients is limited.
- Neurological care, including monitoring and management, is critical for adults on ECMO.
Purpose of the Study:
- To provide evidence-based guidelines for neurological care of adult ECMO patients with ABI.
- To establish consensus recommendations for neurological monitoring and management during and after ECMO.
Main Methods:
- Convened an international multidisciplinary consensus panel of 30 ECMO experts.
- Utilized a modified Delphi process with three rounds of voting to assess recommendation levels.
- Based guidelines on clinical practice consensus and scientific statements.
Main Results:
- Identified five key clinical areas for guidance: neurological monitoring, post-cannulation targets, neurological therapy, prognostication, and follow-up.
- Developed 30 consensus statements and recommendations for ECMO-associated ABI.
- Highlighted knowledge gaps to inform future research.
Conclusions:
- Acute brain injury significantly impacts morbidity and mortality in ECMO patients.
- Early detection and timely intervention are crucial for improving outcomes.
- These recommendations guide neurological monitoring, prevention, and management of ECMO-associated ABI.
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