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; CARE; MORTALITY; ECMO;

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

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