ECMO Random Flashcards
Along with a brief explanation of extracorporeal life support (ELS), discuss the indications and contraindications of ELS (also known as extracorporeal membrane oxygenation-ECMO) for both cardiac and respiratory failure.
ELS
Involves oxygenation of the blood using an extracorporeal circuit
Venovenous ELS is used in refractory respiratory failure when the patient cannot be oxygenated
Deoxygenated blood is removed from the venous circulation and ran through an oxygenator and returned to the venous system in an oxygenated state.
Venoarterial ELS us used in refractory cardiac failure when the heart cannot provide pressure and flow to vital organs
Deoxygenated blood is removed from the venous circulation and passed through an oxygenator and pump and returned to the aorta to provide oxygenated pressurised flow to vital organs
Indications respiratory failure
General
adequate cardiac function
reversible pathology
unsupportable resp failure
Bridge to another therpay (eg transplant)
Specific (where supportive data available)
ARDS with lung injury from pneumonia
Primary graft dysfucntion following lung transplant
Pulm vasculitis
Bronchopulm fistula
Contraindications respiratory failure
Patient refusal
Non reversible condition
Co morbidities or frailty that would preclude a meaningful recovery
Indications cardiac failure
Refractory cardiac arrest as bridge to PCI or hypothermia correction
Refractory cardiogenic shock as bridge to VAD or transplant
Refractory cardiogenic shock in reversible condition such as myocarditis or drug overdose or even PE
Primary graft failure after heart transplant
Contraindications
Non reversible condition
Co morbidities or frailty that would preclude a meaningful recovery
