{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:13:32Z","timestamp":1788416012334,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cardiogenic shock (CS) during venoarterial extracorporeal membrane oxygenation (VA-ECMO) support carries high mortality, often due to neurological injury. Precise matching of ECMO flow to cerebral perfusion is critical. Transcranial color-coded sonography (TCCS) offers real-time, non-invasive hemodynamic assessment to guide flow titration, though its clinical integration remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>This study reports a 58-year-old male firefighter who suffered out-of-hospital cardiac arrest due to acute myocardial infarction, resulting in CS, right frontal lobe hemorrhage, and hypoxic-ischemic encephalopathy. VA-ECMO was initiated on-site and maintained post-resuscitation alongside intra-aortic balloon pump (IABP) and continuous renal replacement therapy (CRRT). TCCS was used throughout hospitalization to monitor middle cerebral artery flow parameters [including pulsatility index (PI), resistivity index (RI), and non-invasive intracranial pressure (nICP)]. These flow indexes were used to guide dynamic ECMO flow adjustments (gradually decreased from 3.25 L\/min to 2.12 L\/min) to preserve cerebral perfusion within target ranges. At the three-month follow-up, his neurological function recovered, and he was living independently. Six-month follow-up revealed progressive resolution of the intracranial hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates the feasibility of TCCS-guided neuromonitoring during ECMO support for CS. TCCS provided real-time cerebral hemodynamic data that informed bedside ECMO flow titration. Whether this approach mitigates secondary brain injury or improves neurological outcomes requires further validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1844563","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:22:48Z","timestamp":1788412968000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A case report of cardiogenic shock with transcranial color-coded ultrasound monitoring under ECMO"],"prefix":"10.3389","volume":"13","author":[{"given":"Yuyi","family":"Chen","sequence":"first","affiliation":[{"name":"Health Management Center, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People\u2019s Hospital)","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyi","family":"Wu","sequence":"additional","affiliation":[{"name":"Guangdong Medical University","place":["Zhanjiang, Guangdong, China"]},{"name":"Department of Critical Care Medicine, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People\u2019s Hospital)","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People\u2019s Hospital)","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefeng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People\u2019s Hospital)","place":["Dongguan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuping","family":"Liao","sequence":"additional","affiliation":[{"name":"Department 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