بایگانی برچسب برای: ECMO

ECMO.in.the.Adult.Patient.[taliem.ir]

ECMO in the Adult Patient

Extracorporeal membrane oxygenation (ECMO) support is a form of extracorporeal life support. ECMO is not a treatment and does not correct the underlying pathological insult .The technology is a direct extension from cardiopulmonary bypass and the heart–lung machine used in cardiac surgery. Extracorporeal life support technologies include other devices, such as dialysis, continuous haemofiltration and ventricular assist devices Table 1.1 lists the main events that contributed to the development of ECMO. Early attempts at mixing gas and blood were hindered by thrombus (blood clot) formation. The discovery of heparin at the start of the 20th century circumvented this obstacle. Various devices to allow mixing of gas and blood were developed, with the bubble oxygenator probably the most recognized. In this system, the gas literally bubbled up in the blood. Great attention to the size of the bubbles and the circuit design with traps allowed this to happen without the air bubbles being entrained into the patient’s bloodstream and causing an air embolism.
Nursing.Care.and.ECMO[taliem.ir]

Nursing Care and ECMO

Directly based on the principle of cardiopulmonary bypass (CPB), short-term circulatory support was developed to supplement heart and/or respiratory failure.Circulatory support is represented by two techniques closely related in their implantation but whose objectives are different. Extracorporeal membrane oxygenation (ECMO) aims to supplement failing lungs, while extracorporeal life support (ECLS) aims to support heart failure. ECMO will primarily affect oxygenation and decarboxylation of blood, while ECLS has a circulatory and a respiratory effect. By extension, the acronym ECMO is used for all short-term circulatory support techniques (under 1 month). To distinguish the two types of assistance, cannulation sites will be identifed. Venoarterial ECMO (ECMO-VA) is used to discuss about ECLS (heart failure or cardiopulmonary failure) and venovenous ECMO (ECMO-VV) to discuss about ECLS (respiratory failure only). The main difference from the commonly used CPB is that ECMO has no cardiotomy reservoir to store the blood. ECMO is therefore a closed circuit. This detail is important because this system is more dependent on the preload and afterload than CBP. The other difference is that CBP will be used over several hours while ECMO may be used for several days or weeks. In 1953, the frst heart–lung machine was used in humans . In 1972, the frst successful use of ECMO outside the operating room was reported . Initially developed for neonatal and paediatric use, these technologies have gradually been applied to adults, with disappointing initial results. A multicentre study evaluating its interest in respiratory failure found no difference from the control group .