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. 2025 Aug 8.
doi: 10.1038/s41372-025-02385-z. Online ahead of print.

Multimodal neuromonitoring modalities of neonatal patients on extracorporeal membrane oxygenation

Allison Young  1 , Luna Vorster  2 , James Riviello Jr  3 , Duy Dinh  4 , Rita Shah  5 , Jennifer Erklauer  3   4 , Amir Navaei  4   6 , Andrea Ontaneda  7
Affiliations

Multimodal neuromonitoring modalities of neonatal patients on extracorporeal membrane oxygenation

Allison Young et al. J Perinatol. .

Abstract

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.

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Conflict of interest statement

Competing interests: The authors declare no competing interests.

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References

    1. Polito A, Barrett CS, Wypij D, Rycus PT, Netto R, Cogo PE, et al. Neurologic complications in neonates supported with extracorporeal membrane oxygenation. An analysis of ELSO registry data. Intensive Care Med. 2013;39:1594–601. https://doi.org/10.1007/s00134-013-2985-x . - DOI - PubMed
    1. Yan K, Tang LK, Xiao FF, Zhang P, Cheng GQ, Wang LS, et al. Brain development in newborns and infants after ECMO. World J Pediatr. 2024;20:556–68. https://doi.org/10.1007/s12519-023-00768-w . - DOI - PubMed - PMC
    1. Andrew M, Paes B, Milner R, Johnston M, Mitchell L, Tollefsen DM, et al. Development of the human coagulation system in the healthy premature infant. Blood. 1988;72:1651–7. https://doi.org/10.1182/blood.v72.5.1651.1651 . - DOI - PubMed
    1. Cashen K, Meert K, Dalton H. Anticoagulation in neonatal ECMO: an enigma despite a lot of effort! Front Pediatr. 2019;7:1–11. https://doi.org/10.3389/fped.2019.00366 . - DOI
    1. Rhee CJ, da Costa CS, Austin T, Brady KM, Czosnyka M, Lee JK. Neonatal cerebrovascular autoregulation. Pediatr Res. 2018;84:602–10. https://doi.org/10.1038/s41390-018-0141-6 . - DOI - PubMed - PMC

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