ECMO Flashcards
What is ECMO
Extracorporeal Membrane Oxygenetion
- Provides prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provided an adequate amount of gas exchange or perfusion to sustain life
Difference between ECMO, ECLS, and ELSO
ECMO = actual device ECLS = Extracorporeal life support (put on ECLS vis ECMO) ELSO = Extracorporeal life support organization - VGH is a hospital that ELSO to patients on ECMO
What is ECMO categorized by? What are the 2 types
According to the circuit used
Veno-Venous
Veno-arterial
How does Veno-venous ECMO work? Does it support lung or heart function?
Venous blood is extracted and returned through the venous side of patients circulation. Supports lung function
How does Veno-arterial ECMO work? Does it support lung or heart function?
Blood is extracted and returned to the arterial side of the patients circulation. Supports lung and heart function (even if they only need cardiac)
What are 3 patient types on ECMO
- bridge to transplant
- Bridge to recover
- Bridge to decision
What are the 2 types of Cannula
Single Lumen
Bi-caval (Avalon)
What does single lumen require
Femoral access - limits mobility
Do you have more flow in a single or bicaval lumen?
Single - People who are really sick will need this
Avalon is only used for
Veno-venous support
is blood 100% saturated with oxygen in VV ECMO?Why?
no - blood enters body and gets pumped to lungs where it is mixed with deoxygenated- ends up being 80% saturated
With what type of ECMO is there risk of cardiac arrest? why?
VA
Pushing it retrograde all the way to aorta
What are important logistical considerations for mobilizing with ECMO
- Have a clear goal of the therapy session
- Check the fixations of the cannulas, check for clots in the circuit
- Have complete visual of circuit
- Set up room, position the ECMO cart/vent where you need them
- inform the patient
- Adequate staffing and clear roles: RT, RN, perfusion, PT
- Contingency plan
When should you start mobilizing on ECMO
Earlier the better (greater weakness with prolonged bed rest) following screening and troubleshooting