ECMO
What is ECMO
An extracorporeal technique providing both cardiac and respiratory support to patients severely diseased heart and lungs
The two circuit sizes we use for ECMO
What is 1/4 inch and 3/8 inch?
The amount of oxygen consumed per minute.
What is VO2?
Can cause serious circuit related thrombosis
Protamine - Contraindicated
3 'C' in ECMO emergency
Clamp
Call for help
Compensate the losses in support with drugs and other measures.
Patients with advanced heart or pulmonary failure may need
Mechanical circulatory support
The ECMO Circuit we use
Centrimag
Breakdown of RBC , High K+, Red or dark brown Urine
Haemolysis
Most common mechanical complication that can occur during ECMO
Clot Formation
ARDS and Lung Contusion
Respiratory failure indications for ECMO
Is an indication of preload.
What is the venous pressure?
Evidence of Hypovolemia
In the form of Fluctuating Flow rates and Chattering of ECMO tubes
Humming and Grinding
Safety check - for Pump
Auscultation for these sounds
When there is a sudden reduction or even loss of flow, what is the first step before clamping the circuit?
What is check circuit pressures?
End-stage Heart Failure
Contraindications of ECMO
Measures the resistance within the oxygenator.
What is the deltaP or Pre/Post membrane pressure?
Blood bank
Patient On ECMO Nurses to ensure 2 PRBC is ready at all times.
Check SVO2 and HCT/Sat connections
Spectrum Monitor
An increasing gradient (difference between pre/post membrane pressure) and increasing RPMs indicate what emergency.
What is oxygenator failure (due to increased resistance)?
Post cardiac arrest and Cardiogenic shock
Cardiac Failure indications of ECMO
Types of ECMO
VA- ECMO
VV ECMO
The phenomenon that occurs during Femoral VA ECMO where the upper half of the patient is pink and the lower half is blue.
What is Harlequin syndrome or differential cyanosis?
The organ in which Heparin is metabolized and excreted.
What is the liver (metabolized) and kidney (excreted)?
Call for help, Clamp return Line, Support the patient
Management of Pump Failure