Optimizing IABP–patient interaction in VA-ECMO via transcranial doppler

In patients receiving veno-arterial extracorporeal membrane oxygenation and intra-aortic balloon pump support, cerebral blood flow may deteriorate if balloon timing is not aligned with the native cardiac cycle. Transcranial Doppler can detect these timing-related neurohemodynamic alterations at the bedside and can confirm their reversibility after simple, ECG-guided optimization of deflation. Integrating transcranial Doppler into multiparametric monitoring may help personalize mechanical circulatory support and protect cerebral perfusion in this high-risk population.