ECMO-/ECLS

The cannulas are secured with 2-0 silk sutures to the skin overlying the mastoid process. A chest x-ray is used to confirm posit ...

support (see Table 1), although the larger the cannula, the greater the flow that can be achieved. In the percutaneous approach, ...

relatively inefficient because of the high resistance associated with the long cannula required to reach the right atrium. A fem ...

while the axillary artery is difficult to dissect and cannulate. In patients under 5 years of age, the femoral and axillary arte ...

higher PEEP during the course on extracorporeal support has been demonstrated to decrease the duration of ECLS.[ 13 ] Since only ...

cannulas and the status of the pulmonary disease. An echocardiogram is used to determine the cardiac physiology and identify any ...

Gas exchange devices (traditionally called oxygenators) are designed to oxygenate and ventilate the blood. “Rated flow” is the a ...

transfer compared to oxygen through the membrane lung, creating a potential for hypocarbia. A gas flow rate equal to blood flow ...

Two basic pump types are available to provide the required blood flow for the patient: a modified roller pump and a centrifugal ...

must have outlet pressure carefully monitored. In neonates, centrifugal pumps may also create more hemolysis than traditional ro ...

III. Physiology A. Indications/Contraindications As with any support technique used in emergent settings, it is critical to cont ...

peak inspiratory pressure  40 cmH 2 O and an A-aDO 2 > 580 mmHg have been used to predict mortality and a need for ECLS init ...

also not considered a contraindication but could be an indication for ECLS at many centers.[ 21 ] Finally, as an ethical conside ...

In contrast, both VV and DLVV support provide adequate gas exchange without these disadvantages, though a fraction of the infuse ...

ECLS circuit or intravenous anesthesia with narcotics, benzodiazepines and paralytics may be employed. Procedures on ELCS includ ...

and allowing recirculation of extracorporeal blood flow through the bridge to prevent thrombosis in the circuit. Although, it is ...

over a longer period of time, especially in view of the high incidence of stenosis. At our institution, we do not routine perfor ...

III. Outcomes As of July 2011, over 46,500 patients were placed on ECLS based on the ELSO registry (see Table 2), with over 34,2 ...

60% using DLVV. Intracranial complications were far less frequent in pediatric patients, though survival was much lower when the ...

follow-up[ 26 ]. In pediatric cardiac patients, ECPR has a survival to discharge of 71% in nonsurgical patients and 46% in posto ...