AI Article Synopsis
- Objective: This study aimed to assess differences in neuromonitoring practices for neonatal ECMO patients in various Level IV NICUs.
- Methodology: Researchers conducted a cross-sectional survey among 34 NICUs, collecting responses from 22 centers on their monitoring practices from June to August 2018.
- Results: Findings revealed considerable variation in practices, with 27% using EEG for seizures, 50% using near infrared spectroscopy, and 95% performing head ultrasounds; 77% conducted MRI screenings before discharge, highlighting a lack of standardized care due to insufficient evidence supporting specific monitoring methods.
Article Abstract
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.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1038/s41372-020-0762-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multi-disciplinary treatment of broncho-esophageal fistula in a high-risk single-lung patient.
J Cardiothorac Surg
January 2025
Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Background: A broncho-esophageal fistula (BEF) is a medical and surgical disaster. Treatment of BEF is often limited to palliative stent treatment that may migrate or cause erosions and tissue necrosis. Surgical repair of BEF is the only established definite treatment.
View Article and Find Full Text PDFFrom Escalate to Elevate: A New Paradigm for Comprehensive Cardiogenic Shock Management.
Can J Cardiol
January 2025
Ted Rogers Centre for Heart Research, University Health Network, Toronto, ON, Canada; Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada. Electronic address:
Patients with cardiogenic shock (CS) present with critical hemodynamic compromise with low cardiac output (CO) resulting in end-organ dysfunction. Prognosis is closely related to the severity of shock and treatment of patients with CS is resource intensive. In this review, we consider the current treatment paradigms alongside the evidence that underpins them.
View Article and Find Full Text PDFThe Management of Postpartum Cardiorespiratory Failure in a Patient with COVID-19 and Sickle Cell Trait Requiring Extraorporeal Membrane Oxygenation Support and Airflight Transportation.
J Clin Med
January 2025
Department of Cardiovascular & Thoracic Anaesthesia and Critical Care, University Hospital of Martinique, F-97200 Fort-de-France, Martinique, France.
Acute cardiovascular disorders are incriminated in up to 33% of maternal deaths, and the presence of sickle cell anemia (SCA) aggravates the risk of peripartum complications. Herein, we present a 24-year-old Caribbean woman with known SCA who developed a vaso-occlusive crisis at 36 weeks of gestation that required emergency Cesarean section. In the early postpartum period, she experienced fever with rapid onset of acute respiratory distress in the context of COVID-19 infection that required tracheal intubation and mechanical ventilatory support with broad-spectrum antibiotics and blood exchange transfusion.
View Article and Find Full Text PDFLocal Anesthetic Infiltration, Awake Veno-Venous Extracorporeal Membrane Oxygenation, and Airway Management for Resection of a Giant Mediastinal Cyst: A Narrative Review and Case Report.
J Clin Med
December 2024
Anesthesiology and Operative Intensive Care, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Mediastinal mass syndrome represents a major threat to respiratory and cardiovascular integrity, with difficult evidence-based risk stratification for interdisciplinary management. We conducted a narrative review concerning risk stratification and difficult airway management of patients presenting with a large mediastinal mass. This is supplemented by a case report illustrating our individual approach for a patient presenting with a subtotal tracheal stenosis due to a large cyst of the thyroid gland.
View Article and Find Full Text PDFPredictive Potential of ECMO Blood Flow for Hemolysis and Outcome of Patients with Severe ARDS.
J Clin Med
December 2024
Department of Anesthesiology and Intensive Care Medicine CCM/CVK Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, 13353 Berlin, Germany.
Treatment with veno-venous extracorporeal membrane oxygenation (VV ECMO) has become a frequently considered rescue therapy in patients with severe acute respiratory distress syndrome (ARDS). Hemolysis is a common complication in patients treated with ECMO. Currently, it is unclear whether increased ECMO blood flow (Q̇) contributes to mortality and might be associated with increased hemolysis.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!