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Extracorporeal Membrane Oxygenation (ECMO) is a procedure that uses a machine to take over the work of the lungs and sometimes the heart. The system provides heart-lung bypass support using a pump to circulate blood through an artificial lung back into the bloodstream, providing enough oxygen to the patient, whilst allowing time for the lungs and heart to rest or heal during or after serious illness. ECMO is often used for babies, but can also be used for children and adults (Medline Plus). The techniques for ECMO require professionals from multidisciplinary background to be involved in the procedure.
Based on the authors’ wealth of clinical experience, this book is a practical guide to the use of ECMO in cardiac and respiratory critical care.
Beginning with an overview of the process, indications and patient selection, equipment and preparation, the next selection provides step by step instruction on initiation and management of ECMO, from cannulation and anticoagulation, to monitoring, ventilation and surgical intervention.
The following section covers complications and troubleshooting, describing clinical scenarios and using algorithms and flowcharts to explain their management.
The final chapters discuss weaning and decannulation, and ancillary issues such as record keeping protocols, the ECMO cart and inventory, and out-of-hospital ECMO.
This third edition has been fully revised and updated to provide clinicians with the latest advances in the field.
Pranay Oza BHMS E-AEC
ECMO Co-Director, Riddhi Vinayak Critical Care and Cardiac Centre, Mumbai, Maharashtra, India
Venkat Goyal MD DM (Cardiology)
Director, Riddhi Vinayak Critical Care and Cardiac Centre, Mumbai, Maharashtra, India
Section 1: ECMO: Basics
- Introduction to Extracorporeal Membrane Oxygenation
- Indication and Selection Criteria
- Extracorporeal Membrane Oxygenation Components
- Circuit Preparation and Priming
Section 2: Initiation and Management
- Pre-extracorporeal Membrane Oxygenation Planning and Preparation
- Protocol for Cannulation
- Protocol for Anticoagulation
- Protocol for Initiation and Stabilization
- Protocol for Monitoring the Patient While on Extracorporeal Membrane Oxygenation
- Management of Patient on Extracorporeal Membrane Oxygenation
- Ventilation During ECMO and Awake ECMO
- Surgical Intervention During Extracorporeal Membrane Oxygenation
- Protocol for Transport and Retrieval of the Patient on Extracorporeal Membrane Oxygenation
Section 3: Complication and Troubleshooting
- Protocol for Managing the Mechanical Complication
- Protocol for Troubleshooting While on ECMO
- Renal Issues and Protocol for Renal Replacement Therapy
- Management of Venoarterial Extracorporeal Membrane Oxygenation Complications
- Management of Venovenous Extracorporeal Membrane Oxygenation Complications
Section 4: Weaning and Decannulation
- Protocol for Weaning and Trial Off
- Carbon Dioxide Removal Device
Section 5: Ancillary Details
- Protocol for Record Keeping
- Extracorporeal Membrane Oxygenation Cart and Inventory
- Protocol for Out-of-Hospital Extracorporeal Membrane Oxygenation