Monitoring brain injuries in extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation is associated with a high incidence of neurologic complications. These complications lead to significant morbidity and mortality. Due to the multifactorial nature of these neurologic injuries, predicting occurrence is difficult. Neuromonitoring plays an important role in ECMO patients, allowing for detection of injury in order to facilitate timely changes in management. For the purpose of this chapter, neuromonitoring will be divided to imaging and non-imaging modalities. The chapter will review the literature and current experiences with the varying types of neuromonitoring that have been utilized in ECMO patients. With a focus on pediatrics, the chapter will explore the indications, advantages, and disadvantages of each approach, and will summarize functional and developmental screens available to follow up patients.