ECMO Basic Concepts Critical Care Canada（加拿大ECMO急救护理的基本概念）.pdf

ECMO Basic Concepts Anne-Marie Guerguerian Critical Care Medicine, The Hospital for Sick Children University of Toronto ecls.program@sickkids.ca Disclosures • Financial: none • Volunteer : • Heart and Stroke Foundation of Canada Resuscitation Paediatric Task Force • International Liaison Committee on Resuscitation Pediatric Task Force 2015 Evidence Reviewer for E-CPR ECLS WHAT IS ECMO? ECMO VAD In the context of caring for the ICU patient with ECMO Extracorporeal Life Support Systems’ Nomenclature ECLS: ExtraCorporeal Life Support ECMO: Extracorporeal Membrane Oxygenation Maquet Rotaflow™ iLA: Interventional Lung Assist ILA Novalung™ by Xenios ECCO R: Extracorporeal Carbon Dioxide Removal 2 VAD: Ventricular Assist Device Long term - LVAD: Berlin ™, Heart Mate ™ Short term - centrifugal cVAD: Maquet Rotaflow™ Levitronix Centrimag® Pedimag™ ECMO is a Type of ECLS 2 Main Physiologic Functions Pulmonary Gas Exchange through an artificial ‘lung’ or MEMBRANE 1. O2 delivery to meet metabolic needs 2. Removal of CO2 Care of patient on ECMO involves exposure to anticoagulation and transfusion therapy O2 Air CO2 Membrane Return of oxygenated blood Drainage of blood to remove CO2 Pump ECLS System: ECMO Patient Oxygen Delivery Key Determinants in ECLS System: • Oxygenation by artificial membrane • Blood flow through the circuit Patient: • Blood flow