Allison Young, Luna Vorster, James Riviello, Duy Dinh, Rita Shah, Jennifer Erklauer, Amir Navaei, Andrea Ontaneda
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Multimodal neuromonitoring modalities of neonatal patients on extracorporeal membrane oxygenation.
Objectives: To describe the neonatal population requiring ECMO; characterize their neurologic injury; summarize multimodal neuromonitoring (MNM) utilized for neonatal ECMO patients; and discern impacts of MNM on patient management.
Study design: This retrospective chart review includes neonates admitted from 2019 to 2023 requiring ECMO. Data include patient characteristics; details of neurologic injury; radiographic, electroencephalogram (EEG), and near-infrared spectroscopy (NIRS) findings; and effects of MNM on patient management.
Results: Among 53 patients, MNM included head ultrasound (53/53, 100%), continuous EEG (35/53,66%), and NIRS (24/53,45%). The frequency of EEG and NIRS monitoring increased after implementing a MNM protocol. Adverse neurologic events were detected in 18 patients (34%). Responses to MNM findings included change in anticoagulation (12/18,67%), recommending additional neuroimaging (11/18,61%), and anti-seizure medication administration (7/18,39%).
Conclusion: MNM during ECMO facilitates timely detection of evolving neurologic injury and informs patient management. Utilizing a MNM protocol increased the number of neonates receiving continuous neuromonitoring.
期刊介绍：
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.
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