Feasibility of non-invasive neuro-monitoring during extracorporeal membrane oxygenation in children

William M McDevitt, Margaret Farley, Darren Martin-Lamb, Timothy J Jones, Kevin P Morris, Stefano Seri, Barnaby R Scholefield

Research output: Contribution to journalArticlepeer-review


Introduction Detection of neurological complications during extracorporeal membrane oxygenation (ECMO) may be enhanced with non-invasive neuro-monitoring. We investigated the feasibility of non-invasive neuro-monitoring in a paediatric intensive care (PIC) setting. Methods In a single centre, prospective cohort study we assessed feasibility of recruitment, and neuro-monitoring via somatosensory evoked potentials (SSEP), electroencephalography (EEG) and near infrared spectroscopy (NIRS) during venoarterial (VA) ECMO in paediatric patients (0–15 years). Measures were obtained within 24h of cannulation, during an intermediate period, and finally at decannulation or echo stress testing. SSEP/EEG/NIRS measures were correlated with neuro-radiology findings, and clinical outcome assessed via the Pediatric cerebral performance category (PCPC) scale 30 days post ECMO cannulation. Results We recruited 14/20 (70%) eligible patients (median age: 9 months; IQR:4–54, 57% male) over an 18-month period, resulting in a total of 42 possible SSEP/EEG/NIRS measurements. Of these, 32/42 (76%) were completed. Missed recordings were due to lack of access/consent within 24 h of cannulation (5/42, 12%) or PIC death/discharge (5/42, 12%). In each patient, the majority of SSEP (8/14, 57%), EEG (8/14, 57%) and NIRS (11/14, 79%) test results were within normal limits. All patients with abnormal neuroradiology (4/10, 40%), and 6/7 (86%) with poor outcome (PCPC ≥4) developed indirect SSEP, EEG or NIRS measures of neurological complications prior to decannulation. No study-related adverse events or neuro-monitoring data interpreting issues were experienced. Conclusion Non-invasive neuro-monitoring (SSEP/EEG/NIRS) during ECMO is feasible and may provide early indication of neurological complications in this high-risk population.
Original languageEnglish
Early online date25 Feb 2022
Publication statusE-pub ahead of print - 25 Feb 2022

Bibliographical note

© Sage 2022. The final publication is available via Sage at http://dx.doi.org/10.1177/02676591211066804


  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Safety Research
  • Radiology, Nuclear Medicine and imaging
  • General Medicine


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