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.