Table 2.

Preclinical models of HIBI in ECMO.

Author, Year	Objective	Animal	Size	ECMO Type	ECMO Duration	Intervention	HIBI Findings
Foerster, 2013 [42]	To investigate the effect of anticoagulation during ECPR	Pig	12	ECPR	60 min	ECPR (80–100 mL/kg/min) started after 15 min of cardiac arrest No anticoagulation before ECPR reperfusion (n = 6) Heparinized saline solution flush (n = 3) Anticoagulant-coated cannulae and normal saline solution flush (n = 3)	No difference between the two groups Brain histology after 7 days of cardiac arrest in both groups showed dark neurons and eosinophilic neurons in hippocampus, cerebellum, and frontal lobe
Putzer, 2021 [43]	To investigate options for the use of ECPR without preceding systemic heparinization after cardiac arrest and the effect on survival and neurological outcome	Pig	14	ECPR	10 min	ECPR (30 mL/kg/min) started after 8 min of cardiac arrest Adrenaline infusion for goal MAP 40 (n = 7) vs. MAP 60 (n = 7)	Microdialysis markers (lactate, pyruvate, and lactate to pyruvate ratio) significantly decreased in MAP 60 group with adrenaline infusion
Rozencwajg, 2023 [44]	To study the impact of the ECMO flow on brain injury	Sheep	6	VA-ECMO	300 min	Low-flow at 2.5 L/min (n = 3) High-flow at 4.5 L/min (n = 3)	Neuronal shrinkage, congestion, and perivascular edema were higher in the low-flow group PbtO2 levels were lower in the low-flow group NIRS was lower in the low-flow group