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

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Názov: Neurological monitoring and management for adult extracorporeal membrane oxygenation patients: Extracorporeal Life Support Organization consensus guidelines: Extracorporeal Life Support Organization consensus guidelines
Autori: Cho, Sung-Min, Hwang, Jaeho, Chiarini, Giovanni, Amer, Marwa, Antonini, Marta V., Barrett, Nicholas, Belohlavek, Jan, Brodie, Daniel, Dalton, Heidi J., Diaz, Rodrigo, Elhazmi, Alyaa, Tahsili-Fahadan, Pouya, Fanning, Jonathon, Fraser, John, Hoskote, Aparna, Jung, Jae-Seung, Lotz, Christopher, MacLaren, Graeme, Peek, Giles, Polito, Angelo, Pudil, Jan, Raman, Lakshmi, Ramanathan, Kollengode, Dos Reis Miranda, Dinis, Rob, Daniel, Salazar Rojas, Leonardo, Taccone, Fabio Silvio, Whitman, Glenn, Zaaqoq, Akram M., Lorusso, Roberto
Zdroj: Crit Care
Informácie o vydavateľovi: Springer Science and Business Media LLC, 2024.
Rok vydania: 2024
Predmety: Adult, Biomedical and clinical sciences, Consensus, Monitoring, Delphi Technique, Neurological care, Acute brain injury, Health sciences, Extracorporeal Membrane Oxygenation/standards [MeSH], Brain Injuries/therapy [MeSH], Neuromonitoring, Adult [MeSH], Guideline, Humans [MeSH], Guidelines, Stroke, Extracorporeal Membrane Oxygenation/methods [MeSH], Monitoring, Physiologic/standards [MeSH], Monitoring, Physiologic/methods [MeSH], ICU care, ECMO, Delphi Technique [MeSH], Brain Injuries/physiopathology [MeSH], Consensus [MeSH], Neurological outcomes, Brain Injuries/therapy physiopathology, Extracorporeal Membrane Oxygenation, Brain Injuries, Physiologic/methods standards, Humans, Extracorporeal Membrane Oxygenation/methods standards, Monitoring, Physiologic
Popis: 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.
Druh dokumentu: Article
Other literature type
Review
Jazyk: English
ISSN: 1364-8535
DOI: 10.1186/s13054-024-05082-z
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39243056
https://pure.eur.nl/en/publications/12bf9d3f-6cbe-4f93-bd66-bca6ac0ca236
https://doi.org/10.1186/s13054-024-05082-z
https://cris.maastrichtuniversity.nl/en/publications/d35fd338-4df0-4594-8840-a41175bf0c24
https://doi.org/10.1186/s13054-024-05082-z
https://repository.publisso.de/resource/frl:6517162
Rights: CC BY
Prístupové číslo: edsair.doi.dedup.....45ac79ee72507e5eca4d2fba8332a44c
Databáza: OpenAIRE
Popis
Abstrakt: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.
ISSN:13648535
DOI:10.1186/s13054-024-05082-z