Acute Crit Care.  2023 Nov;38(4):389-398. 10.4266/acc.2023.01368.

Plasma biomarkers for brain injury in extracorporeal membrane oxygenation

• Kapoor S
• Kolchinski A
• Gusdon AM
• Premraj L
• Cho SM

• KMID: 2550895
• DOI: http://doi.org/10.4266/acc.2023.01368

Abstract

Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for patients with refractory cardiorespiratory failure. Despite its benefits, ECMO carries a significant risk of neurological complications, including acute brain injury (ABI). Although standardized neuromonitoring and neurological care have been shown to improve early detection of ABI, the inability to perform neuroimaging in a timely manner is a major limitation in the accurate diagnosis of neurological complications. Therefore, blood-based biomarkers capable of detecting ongoing brain injury at the bedside are of great clinical significance. This review aims to provide a concise review of the current literature on plasma biomarkers for ABI in patients on ECMO support.

Keyword

acute brain injury; extracorporeal membrane oxygenation; plasma biomarker

Figure

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  Figure 1. Standardized neuromonitoring protocol. ECMO: extracorporeal membrane oxygenation; NIRS: near-infrared spectroscopy; EEG: electroencephalogram; GCS: Glasgow Coma Scale; CT: computed tomography; mRS: modified Rankin Scale; MRI: magnetic resonance imaging. Adapted and Retrieved from Ong CS, et al. J Thorac Cardiovasc Surg 2023;165:2104-10 [4], to which biomarkers could be supplementary once more studied in ECMO.

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  Figure 2. (A) The number of publications over time looking at “biomarker,” “surrogate marker,” or “surrogate endpoint.” (B) The number of publications over time looking at “biomarker”, “surrogate marker” or “surrogate endpoint” and extracorporeal membrane oxygenation.

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