ECMO – Questions With Applicable Solutions
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Terms in this set (67)
-GA >34 wks
-BW >2000 g, SGA shouldn't be excluded
-reversible lung disease
-no significant coagulopathy/uncontrolled bleeding
What is the inclusion -IVH grade 2 or less
criteria for ECMO? -failure with optimal medical management
-no lethal anomalies or brain injuries
-no major cardiac malformations (unless stabilizing
pre/post surgery)
-decision of "full support"
-RDS
-MAS
What conditions are -PPHN
considered for ECMO as -CDH
acute/reversible -Sepsis
pathology? -Pneumonia
-Life support before/after cardiac surgery
-acute respiratory distress syndrome
what imaging must be done HUS and echo (r/o IVH/abnormalities in heart)
before placement on
ECMO?
what should be trialed HFV, volume support, vasopressors, vasodilators,
prior to ECMO surfactant, iNO
cannulation?
-calculations (see photo)
What criteria determines
-Acute deterioration
whether someone is a
candidate for ECMO?
, VA: most common
what are the two types of
ECMO? VV: gaining popularity in NICUs, drains and returns
through venous cannula
-deoxygenated blood drained
from cannula in right internal
jugular through to R atrium
-venous cannula must be a 8-14 fr
to ensure adequate drainage for
What is the technique for
cardiac output needs
VA perfusion?
-oxygenated blood returned
through cannula into right
common carotid to aorta
-60-80% of total cardiac output
through ECMO
provides both respiratory and cardiac support by
decompressing pulmonary circulation and pulmonary
what are the advantages of capillary filtration pressure
VA ECMO?
PPV to minimal parameters, PIP 15-25, PEEP 5-10, RR 10-
20, FiO2 21-30%
-emboli (air or particulate) could be infused into arterial
circulation
-ligation of carotid may be permanent and
what are the disadvantages
subsequently affect cerebral perfusion
of VA ECMO?
-greater potential for left ventricular cardiac stun
(reversible reduction of function of heart contraction
after reperfusion not accounted for by tissue damage)
-double lumen cannula used (12, 14, or 15 fr)
-deoxygenated blood drained from venous limb
positioned in R atrium
how does VV ECMO work?
-blood returned through arterial limb with side holes
positioned at the tricuspid valve
-blood flow through valve into right ventricle
Save
Terms in this set (67)
-GA >34 wks
-BW >2000 g, SGA shouldn't be excluded
-reversible lung disease
-no significant coagulopathy/uncontrolled bleeding
What is the inclusion -IVH grade 2 or less
criteria for ECMO? -failure with optimal medical management
-no lethal anomalies or brain injuries
-no major cardiac malformations (unless stabilizing
pre/post surgery)
-decision of "full support"
-RDS
-MAS
What conditions are -PPHN
considered for ECMO as -CDH
acute/reversible -Sepsis
pathology? -Pneumonia
-Life support before/after cardiac surgery
-acute respiratory distress syndrome
what imaging must be done HUS and echo (r/o IVH/abnormalities in heart)
before placement on
ECMO?
what should be trialed HFV, volume support, vasopressors, vasodilators,
prior to ECMO surfactant, iNO
cannulation?
-calculations (see photo)
What criteria determines
-Acute deterioration
whether someone is a
candidate for ECMO?
, VA: most common
what are the two types of
ECMO? VV: gaining popularity in NICUs, drains and returns
through venous cannula
-deoxygenated blood drained
from cannula in right internal
jugular through to R atrium
-venous cannula must be a 8-14 fr
to ensure adequate drainage for
What is the technique for
cardiac output needs
VA perfusion?
-oxygenated blood returned
through cannula into right
common carotid to aorta
-60-80% of total cardiac output
through ECMO
provides both respiratory and cardiac support by
decompressing pulmonary circulation and pulmonary
what are the advantages of capillary filtration pressure
VA ECMO?
PPV to minimal parameters, PIP 15-25, PEEP 5-10, RR 10-
20, FiO2 21-30%
-emboli (air or particulate) could be infused into arterial
circulation
-ligation of carotid may be permanent and
what are the disadvantages
subsequently affect cerebral perfusion
of VA ECMO?
-greater potential for left ventricular cardiac stun
(reversible reduction of function of heart contraction
after reperfusion not accounted for by tissue damage)
-double lumen cannula used (12, 14, or 15 fr)
-deoxygenated blood drained from venous limb
positioned in R atrium
how does VV ECMO work?
-blood returned through arterial limb with side holes
positioned at the tricuspid valve
-blood flow through valve into right ventricle
