Neurological monitoring and management for adult extracorporeal membrane oxygenation patients

Extracorporeal Life Support Organization consensus guidelines

Cho SM, Hwang J, Chiarini G, Amer M, Antonini MV, Barrett N, Belohlavek J, Brodie D, Dalton HJ, Diaz R, Elhazmi A, Tahsili-Fahadan P, Fanning J, Fraser J, Hoskote A, Jung JS, Lotz C, MacLaren G, Peek G, Polito A, Pudil J, Raman L, Ramanathan K, Dos Reis Miranda D, Rob D, Salazar Rojas L, Taccone FS, Whitman G, Zaaqoq AM, Lorusso R. Crit Care DOI: 10.1186/s13054-024-05082-z

Background: Critical 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.

Methods: These 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.