Neurologic Issues in Patients Receiving Extracorporeal Membrane Oxygenation Support

Extracorporeal membrane oxygenation (ECMO) is a well-established therapy for patients experiencing acute severe cardiac and/or respiratory failure. Unfortunately, despite noteworthy improvements in patient selection, technology, and multidiscipli‐ nary team management, significant complications are still common. The most dramatic and potentially severe complications are neurologic. However, the incidence of neurologic complications (i.e. embolic stroke, intracerebral hemorrhage, seizures, and anoxic injuries) has not been completely defined. Unfortunately, brain death and neurologic injuries are significant causes of morbidity and mortality for patients requiring an ECMO support. Critical to the management of patients requiring ECMO is a broader understanding of neurologic monitoring along with the clinical assess‐ ment and management of neurologic events. It is important to evaluate and potential‐ ly intervene early in the event of a neurologic problem to minimize its clinical significance. Hopefully, with a better understanding of the pathophysiology, diagnos‐ tic and therapeutic tools, and prevention strategies, the true incidence of neurologic complications can be understood and minimized.