Monitoring of Cerebral Oxygen Saturation in Interhospital Transport of Patients Receiving Extracorporeal Membrane Oxygenation.

Extracorporeal membrane oxygenation (ECMO) in acute respiratory distress syndrome (ARDS) is used to achieve oxygenation and protect lung ventilation. Near infrared spectroscopy (NIRS) measures cerebral regional tissue oxygenation (rSO2) and may contribute to patient safety during interhospital transport under ECMO support. We evaluated 16 adult ARDS patients undergoing interhospital ECMO transport by measuring cerebral rSO2 before and after initiation of ECMO support and continuously during transport. To compare peripheral oxygen saturation (SpO2) measurement with rSO2, both parameters were analyzed. NIRS monitoring for initiation of ECMO and interhospital transport under ECMO support was feasible, and there was no significant difference in the percentage of achievable valid measurements over time between cerebral rSO2 (88.4% [95% confidence interval {CI}, 81.3-95.0%]) and standard SpO2 monitoring 91.7% (95% CI, 86.1-94.2%), p = 0.68. No change in cerebral rSO2 was observed before 77% (73.5-81%) (median [interquartile range {IQR}]) and after initiation of ECMO support 78% (75-81%), p = 0.2. NIRS for cerebral rSO2 measurement is feasible during ECMO initiation and interhospital transport. Achievement of valid measurements of cerebral rSO2 was not superior to SpO2. In distinct patients (e.g., shock), measurement of cerebral rSO2 may contribute to improvement of patient safety during interhospital ECMO transport.