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Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines

SM. Cho, J. Hwang, G. Chiarini, M. Amer, MV. Antonini, N. Barrett, J. Belohlavek, D. Brodie, HJ. Dalton, R. Diaz, A. Elhazmi, P. Tahsili-Fahadan, J. Fanning, J. Fraser, A. Hoskote, JS. Jung, C. Lotz, G. MacLaren, G. Peek, A. Polito, J. Pudil, L....

. 2024 ; 28 (1) : 296. [pub] 20240906

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, přehledy

Perzistentní odkaz   https://www.medvik.cz/link/bmc24018973

Grantová podpora
K23 HL157610 NHLBI NIH HHS - United States
1K23HL157610 NIH HHS - United States

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. RESULTS: We 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. CONCLUSIONS: The 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.

2nd Department of Medicine Cardiology and Angiologiy General University Hospital and 1st School of Medicine Charles University Prague Czech Republic

Alfaisal University College of Medicine Riyadh Saudi Arabia

Bufalini Hospital AUSL della Romagna Cesena Italy

Cardiorespiratory and Critical Care Division Great Ormond Street Hospital for Children National Health Service Foundation Trust London UK

Cardiothoracic Intensive Care Unit Department of Cardiac Thoracic and Vascular Surgery National University Health System Singapore Singapore

Cardiothoracic Surgery Department Heart and Vascular Centre Maastricht University Medical Centre Cardiovascular Research Institute Maastricht Maastricht The Netherlands

Congenital Heart Center Departments of Surgery and Pediatrics University of Florida Gainesville FL USA

Critical Care Research Group Adult Intensive Care Services The Prince Charles Hospital and University of Queensland Rode Rd Chermside QLD 4032 Australia

Department of Anaesthesiology Intensive Care Emergency and Pain Medicine University Hospital Würzburg Würzburg Germany

Department of Anesthesiology Division of Critical Care University of Virginia Charlottesville VA USA

Department of Critical Care Medicine Guy's and St Thomas' National Health Service Foundation Trust London UK

Department of Intensive Care Erasmus University Medical Center Rotterdam The Netherlands

Department of Intensive Care Hôpital Universitaire de Bruxelles Brussels Belgium

Department of Pediatrics Section Critical Care Medicine Children's Medical Center at Dallas The University of Texas Southwestern Medical Center at Dallas Dallas TX USA

Department of Thoracic and Cardiovascular Surgery Korea University Medicine Seoul Republic of Korea

Departments of Surgery and Pediatrics Creighton University Omaha NE USA

Division of Anaesthesiology Intensive Care and Emergency Medicine Spedali Civili University Affiliated Hospital of Brescia Brescia Italy

Division of Cardiac Surgery Department of Surgery The Johns Hopkins University School of Medicine Baltimore MD USA

Division of Pulmonary and Critical Care Medicine Department of Medicine The Johns Hopkins University School of Medicine Baltimore MD USA

Divisions 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 Baltimore MD 21287 USA

ECMO Department Fundacion Cardiovascular de Colombia Floridablanca Santander Colombia

Medical Critical Care Service Department of Medicine Inova Fairfax Medical Campus Falls Church VA USA

Medical Critical Pharmacy Division King Faisal Specialist Hospital and Research Center 11564 Al Mathar Ash Shamali Riyadh Saudi Arabia

Pediatric Intensive Care Unit Department of Woman Child and Adolescent Medicine Geneva University Hospital Geneva Switzerland

Programa de Oxigenación Por Membrana Extracorpórea Hospital San Juan de Dios Santiago Santiago Chile

Citace poskytuje Crossref.org

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