[Expert consensus on the assessment of brain injury and determination of brain death during extracorporeal membrane oxygenation support (2025 edition)].

Abstract

Extracorporeal membrane oxygenation (ECMO) serves as a pivotal life-support modality. However, the associated increased brain injury and its prognosis and outcome have raised significant concern. To address these challenges, an interdisciplinary task force comprising neurologists, neurosurgeons, intensivists, emergency physicians, anesthesiologists, pediatricians, and healthcare administrators collaboratively developed the "Expert consensus on the assessment of brain injury and determination of brain death during extracorporeal membrane oxygenation support". Utilizing a modified Delphi methodology and the Oxford Centre for Evidence-Based Medicine 2009 criteria, and guided by 29 clinical issues, the consensus analyzed and discussed 4 themes, including an overview of ECMO, brain injury during ECMO, brain function assessment during ECMO, and brain death determination during ECMO. A total of 8 recommendations were put forward, aiming to provide help and guidance for clinicians and improve the prognosis and outcome of patients.