The following is a summary of “Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines,” published in the September 2024 issue of Critical Care by Cho et al.
The critical care of patients on extracorporeal membrane oxygenation (ECMO) with Acute Brain Injury (ABI) is confined by a lack of high-quality clinical evidence.
Researchers conducted a retrospective study to assess guidelines for neurological care of adults during and after ECMO support.
They assembled an international multidisciplinary consensus panel of 30 clinician-scientists with ECMO professionals from all Extracorporeal Life Support Organization (ELSO) chapters. They used a modified Delphi process with 3 rounds of voting, and panelists evaluated recommendation levels.
The results showed 5 vital clinical areas ought guidance: neurological monitoring, post-cannulation early physiological targets and ABI, neurological therapy, neurological prognostication, and neurological follow-up and outcomes. The consensus process yielded 30 statements and recommendations concerning these areas while highlighting several knowledge gaps for future research.
They concluded that ABI influences morbidity and mortality in patients with ECMO. Early detection and intervention were important for improving results, and the consensus recommendations with scientific statements guide neurological monitoring, ABI prevention, and management strategies.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05082-z
