Limitations of Cerebral Oximetry in a Patient With an Intracerebral Hemorrhage and Brain Edema on Extracorporeal Membrane Oxygenation: A Case Report

Abstract

Regional cerebral tissue saturation monitoring is frequently used in patients on mechanical cardiac assist devices with the intention to promptly detect critical imbalances between cerebral oxygen delivery and oxygen extraction and ultimately circumvent permanent brain injury. We report a case where an intraparenchymal bleed in the supply zone of the middle cerebral artery—followed by severe hemispherical brain edema, leading to life-threatening intracranial hypertension—escaped cerebral oximetry monitoring using near-infrared spectroscopy. Potential explanations for our observation, as well as the specific limitations of these devices, are discussed.

Contraindications to the Initiation of Veno-Venous ECMO for Severe Acute Respiratory Failure in Adults: A Systematic Review and Practical Approach Based on the Current Literature

“…Although life expectancy cannot be reliably predicted today, advanced stages of cancer are generally associated with a reduced life expectancy, and treatments to prolong life in these stages are usually rejected. However, ECMO has been reported to facilitate palliative interventions [ 22 , 23 , 24 , 25 ].…”

“…In Table 1 , the literature from the last 3 decades is summarized with regard to mortality, as well as functional outcome of intracranial hypertensive conditions. There is a paucity of literature on ECMO in these populations [ 22 ], therefore, we tried to establish an analogy.…”