Extracorporeal Membrane Oxygenation (ECMO)

ECMO is a therapy used to treat people with life-threatening heart and lung failure. ECMO involves the use a machine to replace some of the functions of a patient’s lungs or heart, or both simultaneously. While ECMO therapy can be life-saving, it is not itself a treatment. Instead, it provides a kind of bridge, a temporarily replacement that keeps the functions of the heart and lungs going while doctors treat the underlying problem.

1. COMPREHENSIVE ECMO TRAINING MANU JACOB PERFUSIONIST MOH KSA

2. Why do patients need ECMO ECMO is a therapy used to treat people with life-threatening heart and lung failure . ECMO involves the use a machine to replace some of the functions of a patient's lungs or heart, or both simultaneously.

3. How many type of ECMO are there There are two main types of ECMO support : Veno-venous ECMO (VV-ECMO), which is used to support only the lungs . Veno-arterial ECMO (VA-ECMO), which is used to support the lungs and heart .

4. Who are candidates for ECMO

5. Who are not candidates for ECMO

6. Who are not candidates for ECMO Relative Contraindications for VV ECMO   Age > 70 yrs. Body weight: > 140 kg. Trauma with multiple bleeding sites Significant Immunosuppression Recent diagnosis of hematological malignancy

7. What are the challenges of ECMO Bleeding is a high-risk event. ... Clots may form in the ECMO circuit or be introduced into the patient's blood. ... Poor blood flow to the limb may occur. ... Any part of the ECMO circuit or machine can fail.

8. What are the configurations of ECMO cannula There are two separate configurations of ECMO circuit : veno-venous (VV) veno-arterial (VA ). Both types of ECMO involve inserting two cannulas —one for draining the blood from venous system (SVC/IVC) to ECMO circuit, the other one—for returning the oxygenated blood either to RA (VV) or to arterial system (VA)

9. What are the configurations of ECMO cannula?                                 Figure 6 Percutaneous femoro -femoral VA-ECMO. AC, arterial cannula; VC, venous cannula; RR, retrograde reperfusion; VA-ECMO, veno -arterial extracorporeal membrane oxygenation. 

10. Configurations

11. Transesophageal echocardiography, mid-esophageal 93° bicaval view. The tip of the drainage cannula is located in the SVC at the junction between RA and SVC. IVC , inferior vena cava; SVC, superior vena cava; RA, right atrium .

12. Do you need to anticoagulate for ECMO A nticoagulation is required to prevent thrombosis of the cannula, oxygenator, and the circuit tubing while balancing the bleeding risks in the patients .

13. How long does it take to come off ECMO? ECMO is generally continued until the underlying cardiac or lung problem is improved or resolved. The typical course is around five days , but in some cases, ECMO support has been continued for up to 25 to 30 days . Long-term ECMO support increases the chances of complications.

14. S urvival Rates