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

Journal of Perinatology volume 41, pages 830–835 (2021)Cite this article

Subjects

A Correction to this article was published on 18 August 2021

This article has been updated

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.

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Acknowledgements

The authors would like to thank the CHNC and its members for their participation in this survey.

Author information

Authors and Affiliations

  1. University of Washington School of Medicine, Seattle, WA, USA

    Zeenia C. Billimoria, Ulrike Mietzsch & Robert J. DiGeronimo

  2. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Natalie E. Rintoul

  3. Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Kevin M. Sullivan

  4. Emory University School of Medicine, Atlanta, GA, USA

    Shannon E. Hamrick & Sarah Keene

  5. USC Keck School of Medicine, Los Angeles, CA, USA

    Rachel Chapman

  6. Washington University School of Medicine, St. Louis, MO, USA

    Rakesh Rao

  7. The George Washington University School of Medicine, Washington, DC, USA

    An N. Massaro

  8. Ohio State University College of Medicine, Columbus, OH, USA

    Ruth B. Seabrook

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  1. Zeenia C. Billimoria
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Consortia

for the CHNC ECMO Focus Group

Contributions

NR, RD, RC, SK, RS, KS, SH, ZB made contributions to the conception and design of the study. ZB and RD collected the data and analyzed it. NR, RD, RC, SK, RS, KS, SH, ZB, UM, AM interpret the data, drafted the work, revised it critically for important intellectual content and approved the final version to be published.

Corresponding author

Correspondence to Zeenia C. Billimoria.

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The authors declare that they have no conflict of interest.

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The original online version of this article was revised: The author list was updated.

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Cite this article

Billimoria, Z.C., Rintoul, N.E., Sullivan, K.M. et al. Noninvasive neurocritical care monitoring for neonates on extracorporeal membrane oxygenation: where do we stand?. J Perinatol 41, 830–835 (2021). https://doi.org/10.1038/s41372-020-0762-6

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