Neurological Monitoring and Management for Adult Extracorporeal Membrane Oxygenation Patients: Extracorporeal Life Support Organization Consensus Guidelines

被引：2

作者：

Cho, Sung-Min ^{[1
,2
,3
,4
,5
,6
,7
]}

Hwang, Jaeho ^{[1
,2
,3
,4
,5
,6
]}

Chiarini, Giovanni ^{[8
,9
]}

Amer, Marwa ^{[10
,11
]}

Antonini, Marta Velia ^{[12
]}

Barrett, Nicholas ^{[13
]}

Belohlavek, Jan ^{[14
,15
]}

Blatt, Jason E. ^{[11
]}

Brodie, Daniel ^{[12
]}

Dalton, Heidi J. ^{[13
,14
]}

Diaz, Rodrigo ^{[15
]}

Elhazmi, Alyaa ^{[10
,11
]}

Tahsili-Fahadan, Pouya ^{[1
,2
,3
,4
,5
,6
,16
]}

Fanning, Jonathon ^{[17
,18
]}

Fraser, John ^{[17
,18
]}

Hoskote, Aparna ^{[19
]}

Jung, Jae-Seung ^{[20
]}

Lotz, Christopher ^{[21
]}

Maclaren, Graeme ^{[22
]}

Peek, Giles ^{[23
,24
]}

Polito, Angelo ^{[25
]}

Pudil, Jan ^{[14
,15
]}

Raman, Lakshmi ^{[26
]}

Ramanathan, Kollengode ^{[21
]}

Miranda, Dinis Dos Reis ^{[27
]}

Rob, Daniel ^{[14
,15
]}

Rojas, Leonardo Salazar ^{[28
]}

Taccone, Fabio Silvio ^{[29
]}

Whitman, Glenn ^{[7
]}

Zaaqoq, Akram M. ^{[30
]}

Lorusso, Roberto ^{[8
]}

机构：

[1] Johns Hopkins Univ, Sch Med, Dept Neurol, Div Neurosci Crit Care, 600 N Wolfe St,Phipps 455, Baltimore, MD 21287 USA

[2] Johns Hopkins Univ, Dept Neurosurg, Div Neurosci Crit Care, Sch Med, 600 N Wolfe St, Phipps 455, Baltimore, MD 21287 USA

[3] Johns Hopkins Univ, Sch Med, Dept Anaesthesiol & Crit Care Med, Div Neurosci Crit Care, 600 N Wolfe St, Phipps 455, Baltimore, MD 21287 USA

[4] Johns Hopkins Univ, Sch Med, Div Cardiac Surg, Dept Neurol, 600 N Wolfe St, Phipps 455, Baltimore, MD 21287 USA

[5] Johns Hopkins Univ, Sch Med, Div Cardiac Surg, Dept Neurosurg, 600 N Wolfe St, Phipps 455, Baltimore, MD 21287 USA

[6] Johns Hopkins Univ, Sch Med, Dept Anaesthesiol & Crit Care Med, Div Cardiac Surg, 600 N Wolfe St, Phipps 455, Baltimore, MD 21287 USA

[7] Johns Hopkins Univ, Sch Med, Dept Surg, Div Cardiac Surg, Baltimore, MD 21205 USA

[8] Maastricht Univ, Heart & Vasc Ctr, Cardiovasc Res Inst Maastricht, Cardiothorac Surg Dept,Med Ctr, Maastricht, Netherlands

[9] Spedali Civili Univ, Affiliated Hosp Brescia, Div Anesthesiol Intens Care & Emergency Med, Brescia, Italy

[10] King Faisal Specialist Hosp & Res Ctr, Med Crit Pharm Div, Al Mathar Ash Shamali, Riyadh 11564, Saudi Arabia

[11] Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia

[12] AUSL Romagna, Bufalini Hosp, Cesena, Italy

[13] Guys & St Thomas Natl Hlth Serv Fdn Trust, Dept Crit Care Med, London, England

[14] Gen Univ Hosp, Dept Med Cardiol & Angiol 2, Prague, Czech Republic

[15] Charles Univ Prague, Sch Med 1, Prague, Czech Republic

[16] Inova Fairfax Med Campus, Dept Med, Med Crit Care Serv, Falls Church, VA USA

[17] Prince Charles Hosp, Adult Intens Care Serv, Crit Care Res Grp, Rode Rd, Chermside, QLD 4032, Australia

[18] Univ Queensland, Rode Rd, Chermside, QLD 4032, Australia

[19] Great Ormond St Hosp Children Natl Hlth Serv Fdn T, Cardioresp & Crit Care Div, London, England

[20] Korea Univ Med, Dept Thorac & Cardiovasc Surg, Seoul, South Korea

[21] Univ Hosp Wurzburg, Dept Anaesthesiol Intens Care Emergency & Pain Med, Wurzburg, Germany

[22] Natl Univ Hlth Syst, Dept Cardiac Thorac & Vasc Surg, Cardiothorac Intens Care Unit, Singapore, Singapore

[23] Univ Florida, Congenital Heart Ctr, Dept Surg, Gainesville, FL USA

[24] Univ Florida, Congenital Heart Ctr, Dept Pediat, Gainesville, FL USA

[25] Geneva Univ Hosp, Dept Woman Child & Adolescent Med, Pediat Intens Care Unit, Geneva, Switzerland

[26] Univ Texas Southwestern Med Ctr Dallas, Childrens Med Ctr Dallas, Dept Pediat, Sect Crit Care Med, Dallas, TX USA

[27] Erasmus Univ, Med Ctr, Dept Intens Care, Rotterdam, Netherlands

[28] Fdn Cardiovasc Colombia, ECMO Dept, Floridablanca, Santander, Colombia

[29] Univ Libre Bruxelles ULB, Hop Univ Bruxelles HUB, Dept Intens Care, Brussels, Belgium

[30] Univ Virginia, Dept Anesthesiol, Div Crit Care, Charlottesville, VA USA

来源：

ASAIO JOURNAL | 2024年 / 70卷 / 12期

关键词：

ECMO; Guidelines; Neuromonitoring; Neurological care; ICU care; Acute brain injury; Stroke; Neurological outcomes; ACUTE ISCHEMIC-STROKE; ACUTE BRAIN-INJURY; CARDIOPULMONARY-RESUSCITATION; HEMORRHAGIC STROKES; RESPIRATORY-FAILURE; RISK-FACTORS; PUPIL INDEX; ECMO; CARE; PROGNOSTICATION;

D O I：

10.1097/MAT.0000000000002312

中图分类号：

R318 [生物医学工程];

学科分类号：

0831 ;

摘要：

BackgroundCritical care of patients on extracorporeal membrane oxygenation (ECMO) with acute brain injury (ABI) is notable for a lack of high-quality clinical evidence. Here, we offer guidelines for neurological care (neurological monitoring and management) of adults during and after ECMO support.MethodsThese guidelines are based on clinical practice consensus recommendations and scientific statements. We convened an international multidisciplinary consensus panel including 30 clinician-scientists with expertise in ECMO from all chapters of the Extracorporeal Life Support Organization (ELSO). We used a modified Delphi process with three rounds of voting and asked panelists to assess the recommendation levels.ResultsWe identified five key clinical areas needing guidance: (1) neurological monitoring, (2) post-cannulation early physiological targets and ABI, (3) neurological therapy including medical and surgical intervention, (4) neurological prognostication, and (5) neurological follow-up and outcomes. The consensus produced 30 statements and recommendations regarding key clinical areas. We identified several knowledge gaps to shape future research efforts.ConclusionsThe impact of ABI on morbidity and mortality in ECMO patients is significant. Particularly, early detection and timely intervention are crucial for improving outcomes. These consensus recommendations and scientific statements serve to guide the neurological monitoring and prevention of ABI, and management strategy of ECMO-associated ABI.

引用

页码：e169 / e181

页数：13

共 50 条

[31] ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients [J].

Lorusso, Roberto ;

Shekar, Kiran ;

MacLaren, Graeme ;

Schmidt, Matthieu ;

Pellegrino, Vincent ;

Meyns, Bart ;

Haft, Jonathan ;

Vercaemst, Leen ;

Pappalardo, Federico ;

Bermudez, Christian ;

Belohlavek, Jan ;

Hou, Xiaotong ;

Boeken, Udo ;

Castillo, Roberto ;

Donker, Dirk W. ;

Abrams, Darryl ;

Ranucci, Marco ;

Hryniewicz, Kasia ;

Chavez, Ivan ;

Chen, Yih-Sharng ;

Salazar, Leonardo ;

Whitman, Glenn ;

Buscher, Hergen ;

Diaz, Rodrigo ;

Mueller, Thomas ;

Combes, Alain .

ASAIO JOURNAL, 2021, 67 (08) :827-844

[32] Neurologic Injury in Adults Supported With Veno-Venous Extracorporeal Membrane Oxygenation for Respiratory Failure: Findings From the Extracorporeal Life Support Organization Database [J].

Lorusso, Roberto ;

Gelsomino, Sandro ;

Parise, Orlando ;

Di Mauro, Michele ;

Barili, Fabio ;

Geskes, Gijs ;

Vizzardi, Enrico ;

Rycus, Peter T. ;

Muellenbach, Raf ;

Mueller, Thomas ;

Pesenti, Antonio ;

Combes, Alain ;

Peek, Giles ;

Frenckner, Bjorn ;

Di Nardo, Matteo ;

Swol, Justyna ;

Maessen, Jos ;

Thiagarajan, Ravi R. .

CRITICAL CARE MEDICINE, 2017, 45 (08) :1389-1397

[33] Extracorporeal membrane oxygenation for life-threatening asthma refractory to mechanical ventilation: analysis of the Extracorporeal Life Support Organization registry [J].

Yeo, Hye Ju ;

Kim, Dohyung ;

Jeon, Doosoo ;

Kim, Yun Seong ;

Rycus, Peter ;

Cho, Woo Hyun .

CRITICAL CARE, 2017, 21

[34] Prevalence and Impact of Infection during Extracorporeal Membrane Oxygenation in Oncologic Patients: A Retrospective Analysis of the Extracorporeal Life Support Organization (ELSO) Registry [J].

Suzuki, Yota ;

Mao, Rui-Min D. ;

Shah, Nikhil R. ;

Schaeffer, Lawrence ;

Deanda, Abe ;

Radhakrishnan, Ravi S. .

JOURNAL OF INTENSIVE CARE MEDICINE, 2023, 38 (04) :391-398

[35] Centrifugal pumps and hemolysis in pediatric extracorporeal membrane oxygenation (ECMO) patients: An analysis of Extracorporeal Life Support Organization (ELSO) registry data [J].

O'Brien, Ciaran ;

Monteagudo, Julie ;

Schad, Christine ;

Cheung, Eva ;

Middlesworth, William .

JOURNAL OF PEDIATRIC SURGERY, 2017, 52 (06) :975-978

[36] Acute brain injury risk prediction models in venoarterial extracorporeal membrane oxygenation patients with tree-based machine learning: An Extracorporeal Life Support Organization Registry analysis [J].

Kalra, Andrew ;

Bachina, Preetham ;

Shou, Benjamin L. ;

Hwang, Jaeho ;

Barshay, Meylakh ;

Kulkarni, Shreyas ;

Sears, Isaac ;

Eickhoff, Carsten ;

Bermudez, Christian A. ;

Brodie, Daniel ;

Ventetuolo, Corey E. ;

Kim, Bo Soo ;

Whitman, Glenn J. R. ;

Abbasi, Adeel ;

Cho, Sung-Min .

JTCVS OPEN, 2024, 20 :64-88

[37] Management of Extracorporeal Membrane Oxygenation Anticoagulation in the Perioperative Period: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference [J].

Willems, Ariane ;

Anders, Marc M. ;

Garcia, Alejandro V. ;

Vogel, Adam M. ;

Yates, Andrew R. ;

Muszynski, Jennifer A. ;

Alexander, Peta M. A. ;

Steffen, Katherine ;

Emani, Sitaram ;

Gehred, Alison ;

Lyman, Elizabeth ;

Raman, Lakshmi .

PEDIATRIC CRITICAL CARE MEDICINE, 2024, 25 (07) :e53-e65

[38] Recommendations on Monitoring and Replacement of Antithrombin, Fibrinogen, and Von Willebrand Factor in Pediatric Patients on Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference [J].

Zantek, Nicole D. ;

Steiner, Marie E. ;

Teruya, Jun ;

Kreuziger, Lisa Baumann ;

Raffini, Leslie ;

Muszynski, Jennifer A. ;

Alexander, Peta M. A. ;

Gehred, Alison ;

Lyman, Elizabeth ;

Watt, Kevin .

PEDIATRIC CRITICAL CARE MEDICINE, 2024, 25 (07) :e35-e43

[39] Timing of Kidney Replacement Therapy Initiation and Survival During Pediatric Extracorporeal Membrane Oxygenation: An Extracorporeal Life Support Organization Registry Study [J].

Anton-Martin, Pilar ;

Modem, Vinai ;

Bridges, Brian ;

Coronado Munoz, Alvaro ;

Paden, Matthew ;

Ray, Meredith ;

Sandhu, Hitesh S. .

ASAIO JOURNAL, 2024, 70 (07) :609-615

[40] Acute neurological complications in adult patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation support [J].

Mohamed Laimoud ;

Walid Ahmed .

The Egyptian Heart Journal, 72

← 1 2 3 4 5 →