simplebooklet thumbnail

ECMO configurations and associated problems while used for pulmonary support

Clerkship in CVS  Tutor   s Feedback on Homework  Reporter  Dr.           Tutor  Dr.          Presentation Time  2020 03  ...
       Hi                                                       Kate                                                      ...
                                                                                                                          ...
4  Things you need to know about ECMO before you read this article...
ECMO Structure ECMO draining cannula  ECMO return cannula  6
                                                                                                                          ...
ECMO Configurations in common               ECMO Inflow  draining - ECMO outflow  8
                                                                                                        VA   VV           ...
VV                                                                                                                        ...
11  The position of the draining limb affects patient   s ABG
Reversed Differential Cyanosis in VAECMO SaO2 values are different in upper and lower body parts If the recovery of heart ...
VA            Reversed Differential Cyanosis                VA                                                            ...
                     VAECMO                                                                                               ...
                                       VAECMO                                                                             ...
 Over  Recirculation in VV Mode Recirculation fraction  Rf   Q1 Q5  Venovenous ECMO Q1 Q2  ECMO flow Q1  ECMO oxygenated b...
VV            Recirculation VV                                              Recirculation                                 ...
VV ECMO  The distance of two tips affects the severity of recirculation    15 cm
Recirculation                                       Rf                     RV      ECMO pump       RA                     ...
20  This paper says that
21  Factors affect the O2 carrying capacity of ECMO Oxygen delivery DecmoO2 in ml O2  min  DecmoO2   Flow x  Hb  x 0.0134 ...
                                                                                                                      ECMO...
 Poiseuille s law   23                                   4                                                                ...
                                                                                                                          ...
       1   Rf         VVECMO
Recirculation  a   b IVC-RA  b  showed less recirculation Rf  and maintain higher ECMO flow than RA-IVC  a  in previous st...
Rf         a   b          VVECMO                                                                                   IVC    ...
The author   s recent study found   .  28  RA-IVC  multistage cannula in SVC multistage cannula  25 Fr 38 cm  tip side hol...
                         SVC                      multistage cannula                Rf
       2      VA                                                                      reversed differential cyanosis
Reversed Differential Cyanosis in VAECMO SaO2 values are different in upper and lower body parts Check ABG in upper limb S...
      VA            Reversed Differential Cyanosis                                                                        ...
Solution 1  Reducing the Native Cardiac Output  33  Put the multistage cannula in SVC rather than in IVC    More reduce th...
Solution 2  Moving the arterial cannula to SCA  34  Shifting the outflow cannula from FA to SCA Disadvantage Technically m...
                     VAECMO                              SVC   Femoral iliac artery                            VVA ECMO   ...
Solution 3  Using Hybrid mode V-VA Mode Implant an extra outflow cannula into IJV Problem  Difficult flow control     Reci...
                         SVC                      multistage cannula             Reversed Differential Cyanosis in VAECMO ...
                                                                                                3                         ...