Noninvasive neurocritical care monitoring for neonates on extracorporeal membrane oxygenation: where do we stand?

Objective To determine practice variation in the utilization of neuromonitoring modalities in neonatal extracorporeal membrane oxygenation (ECMO) patients across Level IV neonatal intensive care units (NICUs). Study design Cross-sectional survey design using electronic surveys sent to site sponsors...

Full description

Saved in:
Bibliographic Details
Published in:Journal of perinatology 2021-04, Vol.41 (4), p.830-835
Main Authors: Billimoria, Zeenia C., Rintoul, Natalie E., Sullivan, Kevin M., Hamrick, Shannon E., Chapman, Rachel, Mietzsch, Ulrike, Keene, Sarah, Rao, Rakesh, Massaro, An N., Seabrook, Ruth B., DiGeronimo, Robert J.
Format: Article
Language:English
Subjects:
631/378
692/499
Blood oxygenation, Extracorporeal
Consortia
EEG
Extracorporeal membrane oxygenation
Hospitals
Infrared spectroscopy
Intensive care
Intensive care units
Magnetic resonance imaging
Medicine
Medicine & Public Health
Membranes
Methods
Near infrared radiation
Neonatal care
Neonatal intensive care
Neonates
Neurology
Newborn babies
Oxygenation
Patient monitoring
Pediatric Surgery
Pediatrics
Polls & surveys
Seizures
Surveys
Ultrasound
Variation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective To determine practice variation in the utilization of neuromonitoring modalities in neonatal extracorporeal membrane oxygenation (ECMO) patients across Level IV neonatal intensive care units (NICUs). Study design Cross-sectional survey design using electronic surveys sent to site sponsors of a multicenter collaborative of 34 Level IV NICUs of the Children’s Hospitals Neonatal Consortium (CHNC) from June to August 2018. Results We had 22 survey respondents from CHNC ECMO centers. Twenty-seven percent of respondents routinely monitored for seizures using electroencephalogram. Cerebral near infrared spectroscopy was used by 50%. Head ultrasound was performed by 95% but the frequency, duration, and type of views varied. Post ECMO screening brain MRI prior to hospital discharge was routinely performed by 77% of respondents. A majority of centers (95%) performed neurodevelopmental follow-up after hospital discharge. Conclusions There is variation in neuromonitoring practices in Level IV NICUs performing ECMO. Lack of evidence and clear outcome benefits has contributed to practice variation across institutions.
ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-020-0762-6