Table 4.
Consensus recommendations based on modified Delphi on neuromonitoring/neuroimaging tools during ECMO
Recommendations | References |
---|---|
1. Neuromonitoring/Neuroimaging* | |
1.1 Standardized neuromonitoring and neurological expertise for ECMO patients who are at high risk of developing ABI are recommended | 6,32 |
1.2. Continuous cerebral oximetry, to follow ongoing trends and early detection of ABI, especially for those with peripheral VA ECMO, who are at risk for differential hypoxia, is recommended | 15,16,18,19 |
1.3. Intermittent EEG and SSEP, particularly in comatose patients, are recommended. If available, continuous EEG is especially useful to detect non-convulsive seizures in comatose patients | 25 |
1.4. Pupil assessment is recommended. If available, the use of pupillometry should be considered | 7,37 |
1.5. Early neuroimaging for ECMO patients at risk of ABI based on physical examination and neuromonitoring tools is recommended | 32,34–36 |
ABI: acute brain injury; ECMO: extracorporeal membrane oxygenation; EEG: electroencephalography; SSEP: somatosensory evoked potential; VA: venoarterial.
Results of the Delphi survey results are available in the Supplementary Material.