Life Support Technology Research Articles

From intra- to extra-uterine: early phase design of a transfer to extra-uterine life support through medical simulation.

Extra-uterine life support technology could provide a more physiologic alternative for the treatment of extremely premature infants, as it allows further fetal growth and development ex utero. Animal studies have been carried out which involved placing fetuses in a liquid-filled incubator, with oxygen supplied through an oxygenator connected to the umbilical vessels. Hence, by delaying lung exposure to air, further lung development and maturation can take place. This medical intervention requires adjustments to current obstetric procedures to maintain liquid-filled lungs through a so-called transfer procedure. Our objective was to develop obstetric device prototypes that allow clinicians to simulate this birth procedure to safely transfer the infant from the mother's uterus to an extra-uterine life support system. To facilitate a user-centered design, implementation of medical simulation during early phase design of the prototype development was used. First, the requirements for the procedure and devices were established, by reviewing the literature and through interviewing direct stakeholders. The initial transfer device prototypes were tested on maternal and fetal manikins in participatory simulations with clinicians. Through analysis of recordings of the simulations, the prototypes were evaluated on effectiveness, safety and usability with latent conditions being identified and improved. This medical simulation-based design process resulted in the development of a set of surgical prototypes and allowed for knowledge building on obstetric care in an extra-uterine life support context.

Surface Engineering for Endothelium-Mimicking Functions to Combat Infection and Thrombosis in Extracorporeal Life Support Technologies.

Blood-contacting medical devices routinely fail from the cascading effects of biofouling toward infection and thrombosis. Nitric oxide (NO) is an integral part of endothelial homeostasis, maintaining platelet quiescence and facilitating oxidative/nitrosative stress against pathogens. Recently, it is shown that the surface evolution of NO can mediate cell-surface interactions. However, this technique alone cannot prevent the biofouling inherent in device failure with dynamic blood-contacting applications. This work proposes an endothelium-mimicking surface design pairing controlled NO release with an inherently antifouling polyethylene glycol interface (NO+PEG). This simple, robust, and scalable platform develops surface-localized NO availability with surface hydration, leading to a significant reduction in protein adsorption as well as bacteria/platelet adhesion. Further in vivo thrombogenicity studies show a decrease in thrombus formation on NO+PEG interfaces, with preservation of circulating platelet and white blood cell counts, maintenance of activated clotting time, and reduced coagulation cascade activation. It is anticipated that this bio-inspired surface design will enable a facile alternative to existing surface technologies to address clinical manifestations of infection and thrombosis in dynamic blood-contacting environments.

Ruthenium red alleviates post-resuscitation myocardial dysfunction by upregulating mitophagy through inhibition of USP33 in a cardiac arrest rat model

Cardiac arrest (CA) remains a leading cause of death, with suboptimal survival rates despite efforts involving cardiopulmonary resuscitation and advanced life-support technology. Post-resuscitation myocardial dysfunction (PRMD) is an important determinant of patient outcomes. Myocardial ischemia/reperfusion injury underlies this dysfunction. Previous reports have shown that ruthenium red (RR) has a protective effect against cardiac ischemia-reperfusion injury; however, its precise mechanism of action in PRMD remains unclear. This study investigated the effects of RR on PRMD and analyzed its underlying mechanisms. Ventricular fibrillation was induced in rats, which were then subjected to cardiopulmonary resuscitation to establish an experimental CA model. At the onset of return of spontaneous circulation, RR (2.5 mg/kg) was administered intraperitoneally. Our study showed that RR improved myocardial function and reduced the production of oxidative stress markers such as malondialdehyde (MDA), glutathione peroxidase (GSSG), and reactive oxygen species (ROS) production. RR also helped maintain mitochondrial structure and increased ATP and GTP levels. Additionally, RR effectively attenuated myocardial apoptosis. Furthermore, we observed downregulation of proteins closely related to mitophagy, including ubiquitin-specific protease 33 (USP33) and P62, whereas LC3B (microtubule-associated protein light chain 3B) was upregulated. The upregulation of mitophagy may play a critical role in reducing myocardial injury. These results demonstrate that RR may attenuate PRMD by promoting mitophagy through the inhibition of USP33. These effects are likely mediated through diverse mechanisms, including antioxidant activity, apoptosis suppression, and preservation of mitochondrial integrity and energy metabolism. Consequently, RR has emerged as a promising therapeutic approach for addressing post-resuscitation myocardial dysfunction.

Полевые дневники Б.А. Куфтина, руководителя Тунгусской экспедиции, как источники эпохи становления советской этнографии

The article analyzes the travel diaries of the head of the Tunguska expedition of 1927–1928, Boris Kuftin (1892–1953). Methods and materials. Participants of the Tunguska Expedition conducted field research on Lake Baikal and the Far East in places where Evenks, Nanais, Negidals, Nivkhs, Oroches, and Udeges people lived. They collected valuable ethnographic materials about the ethnocultural features of settlement, types of dwellings, fishing activities, life cycle rituals, shamanism, holidays, and features of the language and folklore of the Tunguso-Manchus and Paleoasiats. Field notebooks of B.A. Kuftin are stored in St. Petersburg, in the Museum of Anthropology and Ethnography (the Kunstkamera) of the Russian Academy of Sciences, and contain a large volume of ethnographic and anthropological information, drawings, shamanic texts, and various life support technologies. Results. However, in addition to them, the scientific heritage of the scientist has a travel diary, which reflects personal road observations and impressions of B.A. Kuftin, subjective characteristics of regional transport infrastructure in the first quarter of the 20th century, his own assessments of the development of Siberian and far Eastern historical science, their relationship with world science, and museum business in Eastern Siberia and the Far East. During the route, B.A. Kuftin met a large number of scientists – representatives of different scientific disciplines – who showed aspects of their complex social relations at the time.

Life support technology of beach glamping using renewable energy of sea waves

Life support technology of beach glamping using renewable energy of sea waves

Decision-Making by Hospital Teams Regarding Access and Use of Life-Support Technology and End-of-Life Processes in Critically Ill Adult Patients: A Narrative Review

Death processes have been progressively transferred to hospital spaces due to biomedicalization and the use of technologies, generating important challenges for healthcare systems. The COVID-19 pandemic exposed the lack of unified criteria and principles for a dignified death in the hospital. This study corresponds to a narrative review using Higgins & Green's methodological framework as a reference. A systematized search was carried out with the question: What are the elements considered in the decision-making of hospital teams regarding access and use of life support technology and dying processes in adult critically ill patients? The searches conducted during October 2022 in MEDLINE/PubMed, Scopus, Science Direct, CINAHL, Biblioteca Virtual en Salud (BVS), Cochrane Library, and Scielo identified 1499 records for screening, and 148 were retrieved for full-text review. Eighty-four articles were included in the review, identifying seven categories. The evidence shows variability in decision-making associated with the clinical status of the patient, the criteria of the medical professional, added to structural elements of the health system and political-legal aspects. The literature recommends reflexive, dynamic, flexible, and individualized decision-making processes that consider the patient's preferences, clinical judgment, prognosis, and available resources. Communication, advance care planning, interdisciplinary discussions, external consultations, and the involvement of ethical committees are crucial throughout the process.

Analysis of different standards for life support technology in manned submersible.

Life support technology is one of the most critical technologies in manned submersibles, acting for the pilots of the submersible and thus directly affecting its underwater safety. Due to its importance, many countries and international organizations have proposed standards and specifications for life support technology. This paper presents an overview of the life support technology of manned submersibles, comparing the standards proposed for it. Furthermore, it analyzes the specific data of oxygen supply and carbon dioxide absorption, both of which are critical aspects of life support technology in each standard, and identifies the data that is widely acknowledged and recognized as the basis for establishing ISO standard 22252:2020). Finally, ISO standard data such as oxygen and carbon dioxide concentration are further confirmed by the environmental parameters of manned submersibles such as the Fendouzhe.

Development of Prone Position Ventilation Device and Study on the Application Effect of Combined Life Support Technology in Critically Ill Patients.

This study aims to evaluate a novel prone position ventilation device designed to enhance patient safety, improve comfort, and reduce adverse events, facilitating prolonged tolerance in critically ill patients. A randomized controlled trial was conducted on 60 critically ill patients from January 2020 to June 2023. Of which, one self-discharged during treatment and another was terminated due to decreased oxygenation, leaving an effective sample of 58 patients. Patients were allocated to either a control group receiving traditional prone positioning aids (ordinary sponge pads and pillows) or an intervention group using a newly developed adjustable prone positioning device. A subset of patients in each group also received life support technologies such as extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). We assessed prone position ventilation tolerance, oxygen saturation increments postintervention, duration of prone positioning, CRRT filter lifespan, and the incidence of adverse events. The intervention group exhibited significantly longer average tolerance to prone positioning (16.6 hours vs. 8.3 hours, P < 0.001 with a difference of 8.3 (4.4, 12.2) hours), higher increases in oxygen saturation postventilation (9% vs. 6%, P < 0.001 with a difference of 3.0 (1.5, 4.5)), and reduced time required for medical staff to position patients (11.7 min vs. 21.8 min, P < 0.001 with a difference of -10.1 (-11.9, -8.3)). Adverse events, including catheter displacement or blockage, facial edema, pressure injuries, and vomiting or aspiration, were markedly lower in the intervention group, with statistical significance (P < 0.05). In patients receiving combined life support, the intervention group demonstrated improved catheter blood drainage and extended CRRT filter longevity. The newly developed adjustable prone ventilation device significantly improves tolerance to prone positioning, enhances oxygenation, and minimizes adverse events in critically ill patients, thereby also facilitating the effective application of life support technologies.

Simulation-based development: shaping clinical procedures for extra-uterine life support technology

BackgroundResearch into Artificial Placenta and Artificial Womb (APAW) technology for extremely premature infants (born < 28 weeks of gestation) is currently being conducted in animal studies and shows promising results. Because of the unprecedented nature of a potential treatment and the high-risk and low incidence of occurrence, translation to the human condition is a complex task. Consequently, the obstetric procedure, the act of transferring the infant from the pregnant woman to the APAW system, has not yet been established for human patients. The use of simulation-based user-centered development allows for a safe environment in which protocols and devices can be conceptualized and tested. Our aim is to use participatory design principles in a simulation context, to gain and integrate the user perspectives in the early design phase of a protocol for this novel procedure.MethodsSimulation protocols and prototypes were developed using an iterative participatory design approach; usability testing, including general and task-specific feedback, was obtained from participants with clinical expertise from a range of disciplines. The procedure made use of fetal and maternal manikins and included animations and protocol task cards.ResultsPhysical simulation with the active participation of clinicians led to the diffusion of tacit knowledge and an iteratively formed shared understanding of the requirements and values that needed to be implemented in the procedure. At each sequel, participant input was translated into simulation protocols and design adjustments.ConclusionThis work demonstrates that simulation-based participatory design can aid in shaping the future of clinical procedure and product development and rehearsing future implementation with healthcare professionals.

A multipurpose Extracorporeal Life Support Circuit: a concept for multiorgan transplant and circulatory support service Healthcare provider

The demand for efficient and adaptable life support systems in the field of Extracorporeal Life Support (ECLS) is steadily increasing. To meet this growing need, there is a requirement for a versatile extracorporeal life support circuit that can be effectively applied in various medical scenarios, especially in tertiary hospitals where multiple ECLS services are utilized. These services include Extracorporeal Membrane Oxygenation (ECMO) for addressing respiratory or cardiac problems, Ventricular Assist Device (VAD) as a bridge to recovery or heart transplant, and Venovenous Bypass (VVB) for assisting liver transplantation. In light of this, we propose the creation of a multipurpose circuit that integrates multiple extracorporeal life support (ECLS) functions to cater to diverse medical needs. This innovative circuit not only offers cost-effectiveness and enhanced safety but also ensures optimal utilization, thereby revolutionizing the realm of life support technologies.

Development of the on-orbit maintenance and manipulation workbench (MMW) for the Chinese space station

The logistic supply for Space Station is very expensive and difficult compared with any other human natural exploration activities due to launch costs and challenges, and the logistic problems of establishing bases on the Moon and Mars in the future will be more prominent. Especially for emergencies, the losses caused by ground support delay will be immeasurable. Considering the successful maintenance of the Hubble Telescope and operations on the ISS, one of the most effective methods to solve the logistic supply problem is to enhance the capability of self-maintenance and support of the facilities. Through the participation of astronauts and a series of tools and technical support, the capability of self-maintenance and support of the facilities can be effectively improved. For this purpose, the on-orbit Maintenance and Manipulation Workbench (MMW) has been developed and installed on the Mengtian Lab Module (MLM) of the Chinese Space Station (CSS) to provide an enclosed working area for on-orbit fault diagnosis, maintenance, and manual or mechanical operations for the payload. This paper introduces the development and functions of the MMW on the MLM. In the limited rack space and limited resources, the MMW provides a 380-L work volume, 1000-W DC power with a versatile supply interface (100, 28, and 12 Vdc), 800-W cooling capability, video and data recording and real-time downlink capabilities, ground commanding capability, wastes (waste gases and waste particles) treatment capabilities. With these capabilities, the MMW is an ideal platform to support the operation and test verification of fine mechanical operations, structural and electronic assembly of scientific experiments and technical experiments in the cabin, and to support the development of space robots and telescience technology experiments. Areas of research that will benefit from investigations in the MMW include fluid physics, materials science, combustion science, on-orbit maintenance and manipulation, and advanced life support technologies. The mechanical, electrical and thermal control subsystems are discussed separately. Special tests for the treatment of wastes have been carried out to verify the capabilities. The development of the MMW will surely enhance the space research in the forthcoming long-term activities of CSS.

The hemodynamic interplay between pulmonary ischemia-reperfusion injury and right ventricular function in lung transplantation: A translational porcine model.

Lung transplantation is a challenging procedure. Following the process of ischemia-reperfusion injury, the transplanted pulmonary graft might become severely damaged, resulting in primary graft dysfunction. Additionally, during the intra-operative window, the right ventricle is at risk of acute failure. The interaction of right ventricular function with lung injury, is however, poorly understood. We aimed to address this interaction in a translational porcine model of pulmonary ischemia-reperfusion injury. Advanced pulmonary and hemodynamic assessment was used, including right ventricular pressure-volume loop analysis. The acute model was based on clamping and unclamping of the left lung hilus, respecting the different hemodynamic phases of a clinical lung transplantation. We found that forcing entire right ventricular cardiac output through a lung suffering from ischemia-reperfusion injury increased afterload (pulmonary vascular resistance from baseline to end experiment p <0.0001) and induced right ventricular failure in 5/9 animals. Notably, we identified different compensation patterns in failing versus non-failing ventricles (arterial elastance p=0.0008; stroke volume p <0.0001). Furthermore, increased vascular pressure and flow produced by the right ventricle resulted in higher pulmonary injury, as measured by ex-vivo CT density (correlation: pressure r=0.8; flow r= 0.85). Finally, RV ischemia as measured by troponin-T was negatively correlated with pulmonary injury (r=-0.76), however, troponin-T values did not determine RVF in all animals. In conclusion, we demonstrate a delicate balance between development of pulmonary ischemia-reperfusion injury and right ventricular function during lung transplantation. Furthermore, we provide a physiological basis for potential benefit of extracorporeal life support technology.

Acute Hypercapnic Respiratory Failure in COPD.

COPD is a progressive inflammatory process affecting both the airways and alveolar structures of the lungs. Exacerbations of COPD are episodes of acute worsening of this inflammatory process, often triggered by infections. The most severe exacerbations are characterized by substantial air trapping and inspiratory muscle overload, which leads to hypercapnic respiratory failure. Pharmacologic therapies focus on intense bronchodilator administration (usually by aerosol), corticosteroids, and antibiotics. Respiratory life support technologies are often needed for severe exacerbations and range from carefully titrated supplemental O2 administration to positive-pressure ventilation (both invasive and noninvasive). Future life support strategies will likely involve extracorporeal life support technologies.

ANALYSIS OF THE ACTIVITIES OF THE DEPARTMENT OF ANESTHESIOLOGY AND INTENSIVE CARE of KazIOR FOR 2021-2022

Relevance: The Department of Anesthesiology and Intensive Care of the Kazakh Research Institute of Oncology and Radiology is an organized system for providing care to oncological patients, which consists of anesthetic support for all types of oncosurgical operations, postoperative intensive therapy, intensive care for patients in cases of life-threatening conditions during radiation and chemotherapy. High-quality care is possible only with an appropriate level of professional training of medical and nursing staff and a sufficient provision of life support and monitoring technologies, medicines, and medical products.&#x0D; The study aimed to analyze the work of the Department of Anesthesiology and Intensive Care in 2021-2022 to further improve the quality of specialized anesthetic and resuscitation care to oncological patients in KazIOR.&#x0D; Methods: The reporting documentation on clinical activities of the Department of Anesthesiology and Intensive Care for 2021 and 2022 was analyzed.&#x0D; Results: In 2021-2022, 5517 anesthesias were performed. While the number of anesthesias in 2022 increased by 9.2%, the structure of the types of anesthesia performed remains unchanged. Anesthetic complications were 0.27%, with no anesthetic mortality. The number of patients admitted to postoperative intensive care in 2022 decreased by 6%. The share of patients re-admitted to the Department of Anesthesiology and Intensive Care was 2.1% in 2021 and 2.7% in 2022. The proportion of elderly and senile patients accounted for more than 40% of the intensive care department patients. In 40% of cases, patients suffered from chronic diseases of the cardiovascular system. Mortality at the Department of Anesthesiology and Intensive Care for the analyzed period was 42 cases, of which postoperative were 25 cases, while postoperative mortality remains approximately at the same level, and in-hospital and general mortality has slightly increased.&#x0D; Conclusion: The reporting documentation analysis for 2021-2022 showed that the number of anesthesia performed and the total number of patients treated in the Department of Anesthesiology and Intensive Care increases annually, which requires further improvement and modernization of the anesthesiology and intensive care service in oncology.

The development of neurocritical care in China from the perspective of evaluation and treatment of critical neurological diseases.

To understand the varieties, evaluation, treatment, and prognosis of severe neurological diseases using the third NCU survey in China. A cross-sectional questionnaire study. The study was completed in three main steps: filling in the questionnaire, sorting out the survey data, and analyzing the survey data. Of 206 NCUs, 165 (80%) provided relatively complete information. It was estimated that 96,201 patients with severe neurological diseases were diagnosed and treated throughout the year, with an average fatality rate of 4.1%. The most prevalent severe neurological disease was cerebrovascular disease (55.2%). The most prevalent comorbidity was hypertension (56.7%). The most prevalent complication was hypoproteinemia (24.2%). The most common nosocomial infection was hospital-acquired pneumonia (10.6%). The GCS, APACHE II, EEG, and TCD were the most commonly used (62.4-95.2%). The implementation rate of the five nursing evaluation techniques reached 55.8-90.9%. Routinely raising the head of the bed by 30°, endotracheal intubation and central venous catheterization were the mostprevalent treatment strategies (97.6, 94.5, and 90.3%, respectively). Traditional tracheotomy, invasive mechanical ventilation and nasogastric tube feeding (75.8, 95.8, and 95.8%, respectively) were more common than percutaneous tracheotomy, non-invasive mechanical ventilation and nasogastric tube insertion (57.6, 57.6, and 66.7%, respectively). Body surface hypothermia brain protection technology was more commonly used than intravascular hypothermia technology (67.3 > 6.1%). The rates of minimally invasive hematoma removal and ventricular puncture were only 40.0 and 45.5%, respectively. In addition to traditional recognized basic life assessment and support technology, it is necessary to the use of promote specialized technology for neurological diseases, according to the characteristics of critical neurological diseases.

Türkiye'de Beyin Ölümü Vakalarında Klinik Etik, Kişisel Değerler, Yasal Belirsizlikler ve Olası Çatışmalar: Bir Uygulamalı Çalışma

Both clinically and legally, brain death has long been recognized as death. However, many people including patient relatives still equate death with cardiopulmonary death (irreversible cessation of heartbeat and breathing), and thus may oppose withdrawal of life-support technologies and refuse to consider organ donation in brain death. Such reactions may lead to problematic or dilemmatic situations in relation to the norms and practices of justice, beneficence, paternalism, futile care, defensive medicine, due care, consideration of personal beliefs and values and financial and emotional burdens, etc. Although the determination of brain death and procedures of organ donation have been legally regulated in Türkiye since the late twentieth century, there have also been legal uncertainties about the decision to terminate care, particularly the extent to which the decision depends on the agreement of patient relatives. With consideration of historical developments, legal documents, ethical issues, and personal attitudes, the present study aimed to analyze the nature of such conflicts between patient relatives (agents that act with subjective priorities) and health-care providers (agents that should act within certain standards) as the two parties in a typical case of brain death. For particular emphasis on the pivotal role of information and communication in the resolution of potential conflicts in real cases of brain death, the discussion was made with application in a hypothetical case.

Multidisciplinary Learning Using Online Networking in Biomedical Engineering

Multifaceted thinking is important to tackle global issues for a sustainable society. It is difficult to select useful information from big data with one-sided thinking. This article takes as an example the controversy related to "vaccines" and "masks" in pandemics. Online education is useful to help control of infectious diseases. Face-to-face group meetings make it easy to interrupt group activities for individual activities. Online meetings are considering various ideas as an alternative to face-to-face meetings. The field of biomedical engineering includes faculties and students from diverse backgrounds. "Cross-cultural exchange" is also useful for multifaceted experiences. With the keyword "life support technology," a Japanese academic society and a Thai university conducted online networking for information exchange. The academic society is working to encourage students. The university is developing new fields. Information exchange is expected to lead to further developments in complex fields. It is expected to lead to the development of human resources that can deal with global problems.

MiR-9a-5p alleviates ventilator-induced lung injury in rats by inhibiting the activation of the MAPK signaling pathway via CXCR4 expression downregulation

BackgroundGlobally, Mechanical ventilation is the most commonly used short-term life support technology. Ventilator-induced lung injury (VILI) is an inflammatory injury caused by mechanical ventilation. MicroRNAs (miRNAs) are considered as new gene regulators that play an important role in lung injury and inflammation. However, the role and mechanism of action of miR-9a-5p in VILI remain unclear. MethodsHerein, a rat model of VILI was established. To determine the expression levels of miR-9a-5p and CXCR4 mRNA, real-time quantitative polymerase chain reactions (qRT-PCR) were conducted. As well as western blot (WB) and immunofluorescence analyses, we determined the expression of CXCR4, SDF-1 and MAPK signaling pathway-related kinases. Hematoxylin and eosin (H&E) staining and the wet-dry ratio of the lung tissue were used to evaluate organ injury. An enzyme-linked immunosorbent assay (Elisa) and myeloperoxidase (MPO) activity measurements were performed to evaluate the inflammatory response. In addition, double luciferase reporter assays were used to verify the association between miR-9a-5p and CXCR4. ResultsThe expression of miR-9a-5p was low, whereas that of CXCR4 was high in the lung tissues of VILI rats. The overexpression of miR-9a-5p alleviated the degree of pathological injury in the lung tissues of rats with VILI, downregulating inflammatory cytokine expression and MPO activity. In the VILI rat model, miR-9a-5p targeted the negative regulation of CXCR4, and CXCR4 overexpression to reverse the lung-protective and anti-inflammatory effects of miR-9a-5p overexpression in VILI rats. miR-9a-5p also inhibited the phosphorylation of extracellular signal receptor-activated kinase (ERK), a protein related to the MAPK signaling pathway, by downregulating CXCR4 expression. ConclusionmiR-9a-5p can hinder the activation of the MAPK/ERK signaling pathway and reduce inflammatory reactions and lung injury in VILI rats through the targeted regulation of CXCR4 expression. Therefore, miR-9a-5p could serve as an intervention target to supply a new strategy for the care of VILI.

Plants in Microgravity: Molecular and Technological Perspectives.

Plants are vital components of our ecosystem for a balanced life here on Earth, as a source of both food and oxygen for survival. Recent space exploration has extended the field of plant biology, allowing for future studies on life support farming on distant planets. This exploration will utilize life support technologies for long-term human space flights and settlements. Such longer space missions will depend on the supply of clean air, food, and proper waste management. The ubiquitous force of gravity is known to impact plant growth and development. Despite this, we still have limited knowledge about how plants can sense and adapt to microgravity in space. Thus, the ability of plants to survive in microgravity in space settings becomes an intriguing topic to be investigated in detail. The new knowledge could be applied to provide food for astronaut missions to space and could also teach us more about how plants can adapt to unique environments. Here, we briefly review and discuss the current knowledge about plant gravity-sensing mechanisms and the experimental possibilities to research microgravity-effects on plants either on the Earth or in orbit.

ECMO in neonates: The association between cerebral hemodynamics with neurological function.

Extracorporeal membrane oxygenation (ECMO) is a superior life support technology, commonly employed in critical patients with severe respiratory or hemodynamic failure to provide effective respiratory and circulatory support, which is especially recommended for the treatment of critical neonates. However, the vascular management of neonates with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is still under controversy. Reconstruction or ligation for the right common carotid artery (RCCA) after ECMO is inconclusive. This review summarized the existed studies on hemodynamics and neurological function after vascular ligation or reconstruction hoping to provide better strategies for vessel management in newborns after ECMO. After reconstruction, the right cerebral blood flow can increase immediately, and the normal blood supply can be restored rapidly. But the reconstructed vessel may be occluded and stenotic in long-term follow-ups. Ligation may cause lateralization damage, but there could be no significant effect owing to the establishment of collateral circulation. The completion of the circle of Willis, the congenital anomalies of cerebral or cervical vasculature, the duration of ECMO, and the vascular condition at the site of arterial catheterization should be assessed carefully before making the decision. It is also necessary to follow up on the reconstructed vessel sustainability, and the association between cerebral hemodynamics and neurological function requires further large-scale multi-center studies.