Cerebral Oximetry, Pulmonary Artery Catheter Parameters and ECMO Flow in Patients Supported With Veno-arterial ECMO

for patients connected to VA ECMO due to cardiogenic shock, monitoring:

• Cerebral Oximetry

Bilateral frontal sensors, rScO₂ recorded:

at baseline (within 1 hour of ECMO initiation) then every 12 hours.

• ECMO Parameters Pump speed (RPM) ECMO blood flow (L/min) every 12 hours. Sweep gas flow Cannulation configuration Arterial cannulation site
• Pulmonary Artery Catheter Data and hemodynamics:

Cardiac output / cardiac index every 12 hours. SvO₂. Central venous pressure (CVP) Mean pulmonary artery pressure. Pulmonary capillary wedge pressure. Systemic vascular resistance.

• Echocardiography parameters: recorded every 12 hours. LV ejection fraction. LVOT VTi. LVED dimension. Aortic valve opening.
• Other variables:

P/F ratio. MAP. Heart rate. Arterial blood gases. Lactate. Hemoglobin. Vasopressor / inotrope doses. Sedation score (RASS).

• Follow-up data:

• ECMO duration.
• Need for oxygen therapy/mechanical ventilation.
• ICU survival.

Inclusion criteria

• Age ≥ 18 years
• Patients supported with veno-arterial ECMO.
• Presence of a pulmonary artery catheter.
• Expected ECMO support ≥ 24 hours.
• Patient with good echocardiographic window.

Exclusion criteria

• Pre-existing severe neurological injury (e.g. massive stroke, traumatic brain injury).
• Intracranial pathology affecting NIRS reliability.
• Facial or scalp conditions preventing NIRS probe placement.
• ECMO duration < 48 hours.
• Poor echocardiographic window.