1 / 28

ECMO AT THE U of M

ECMO AT THE U of M. Two era’s 1974 & 1986 1974 - 12 patients. Kolobow Membrane Lung – Roller Pump – Adult and Peds. Patients. No Survivors 1986 to present - ? Patients. Several different oxygenators, Centrifugal pump only! ?% overall survival. CIRCIUTS FOR ECMO. ARTERIAL VENOUS

ainsley-carpenter
Télécharger la présentation

ECMO AT THE U of M

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ECMO AT THE U of M • Two era’s 1974 & 1986 • 1974 - 12 patients. Kolobow Membrane Lung – Roller Pump – Adult and Peds. Patients. No Survivors • 1986 to present - ? Patients. Several different oxygenators, Centrifugal pump only! • ?% overall survival

  2. CIRCIUTS FOR ECMO • ARTERIAL VENOUS • VENOVENOUS • PERIPHERAL • CENTRAL (OPEN CHEST)

  3. CANNULATION TECHNIQUE NEONATE PERIPHERAL • Neck cannulation • Positioning of patient • Sedation • Surgical Prep • Ideal Cannulae Position

  4. Ideal Arterial Cannula Placement A V ECMO • Cannula in Ascending Aorta just above Aortic valve (adjacent coronary ostia) • Supplies oxygenated blood to coronaries and the rest of the circulation. • Cannula tip should avoid proximity with the Aortic valve leaflets and stay out of left ventricle.

  5. SINGLE CANNULA VENOVENOUS • Dual luman cannula • Smallest size 14 fr. - limits use to patients above 4 kg. • 15 Fr. – 4kg to < 9kg two lenghts • Flow recirculation 15-30% • Requires higher flows • No lung rest - must ventilate • Requires good cardiac function

  6. VENEO/VENOUS IN ADULTS Peripheral cannulation • Drainage from Femoral vein • Return SVC via Jugular access (Or visa versa) • Access may be percutanious or direct cut down • Percutanious is better (less bleeding) • Requires ventilation (no lung rest) • Requires good cardiac function

  7. VENO/ARTERIAL ADULTS • Peripheral -Femoral vein, Femoral Artery • Limited distribution of blood centrally • Must have reversal of flow in Aorta for oxygenated blood to reach Heart and Brain • Must place distal perfusion cannula in Femoral artery • Central cannulation - Aorta, Rt. Atrium • Complete cardiopulmonary support

More Related