Aliases:
ECCMO
ECMO

Topic aliases are alternate phrasings for a particular topic.


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In patients with acidemia and impaired myocardial function VV ECMO may improve the patient's metabolic derangement resulting in improved myocardial function. This may avoid the need for VA ECMO.
#alfredecmo

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Apr 02, 2014
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Indications (neonates):
Primary pulmonary-hypertension-of-newborn PPHN, respiratory distress-syndrome, meconium aspiration-syndrome, group B streptococcal sepsis, congenital diaphragmatic-hernia

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Feb 26, 2013
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Qualifying criteria :
A-a gradient >600 for >4hrs;
oxygenation index >40 in 3 of 5 post-ductal gas 30min apart;
acute deterioration (PaO2 <40mmHg >2hrs,
pH <7.25 >2hrs,
intractable hypotension. #ref

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Mar 31, 2013
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Causes of hypoxia on VV ECMO.

1. recirculation
2. Cardiac output > ECMO flow
3. Oxygenator failure

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Apr 02, 2014
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Differential hypoxia may occur in patients on peripheral VA ECMO with poor lungs. Pulse oximetry on the right arm will better reflect cerebral oxygenation.
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Apr 02, 2014
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Example of clot

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May 23, 2013
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Will require measurement of ACT. Ensure functioning equipment available.

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Feb 26, 2013
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Extension tubing under drapes to foot of bed to anaesthetist/intensivist.

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Mar 12, 2012
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Calcium replacement may be prudent as the patient is connected to the ECMO circuit as the prime blood is citrated and may precipitate hypocalcemia and particularly in neonates, reduced myocardial contractility.

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Jul 08, 2013
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Heparin 100u/kg prior to first cannulation. Ask surgeon when to administer.

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Jul 08, 2013
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A means of assessing whether peripheral VA ECMO is providing adequately oxygenated blood to the brain is to look at the oximetry in the right hand.

Adequately oxygenated blood in the right hand suggests that oxygenated blood from the arterial ECMO cannula is reaching the right subclavian artery and hence likely the brain via the carotids.

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Jul 26, 2013
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If considering defibrillation whilst on ECMO consider the risk that the physical jolt may disrupt cannula connections.

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Oct 24, 2012
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Ensure blood is crossmatched & available in the room. For paediatrics, have blood prepared in a 50ml syringe to administer as needed.

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May 22, 2013
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Normal ranges of plasma free Hb in patients on ECMO

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Apr 01, 2014
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Precalculate allowable blood-loss (ABL) and transfuse appropriately

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Nov 15, 2012
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Fever is an unreliable sign of infection in patients on ECMO as temperature is regulated by the circuit.

#TD

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Mar 31, 2013
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