Pozzebon S, et al. - The role of rSO₂ (cortical oxygen tissue saturation) monitoring in identifying acute cerebral complications (ACC) and desaturations and their association with poor outcome when employing veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was determined. Given that ACC of VA-ECMO are associated with poor long-term neurologic outcome. rSO₂ monitoring could be considered as an interesting tool to monitor the brain of patients on VA-ECMO. An independent association was noted between the occurrence of cerebral desaturation as well as high lactate concentrations during the first 4 days of ECMO and hospital mortality. Compared with other patients, patients with ACC more frequently developed cerebral desaturation and had a lower minimal rSO₂ over time and more frequently had high right-left rSO₂ differences, both of which independently predicted ACC.