ECMO-/ECLS

(Marcin) #1

conjunction with vasopressor agents. Milrinone works synergistically with inhaled
prostacyclin in the same signaling axis.
ECMO: Decision to institute ECMO support is a complex process and involves
coordination of services. Pre-ECMO studies typically done are cardiac ECHO to rule out
CHD and head US to rule out IVH. Although OI>40 are typically used for consideration
of ECMO, overall assessment of cardiopulmonary stability is more important than any
single number.


MEASURES OF OXYGENATION


A-a GRADIENT
Alveolar PO2 = PAO2
Alveolar PCO2 = PACO2
In 100% O2, PAO2 = Atmospheric pressure - water vapor pressure - PACO2
Assume PACO2 = PaCO2


PAO2 = Atmospheric pressure - water vapor pressure - PACO2


= (760 - 47 - PACO2/0.8)


Alveolar-arterial gradient is calculated by:
A-a Gradient = (713 - PACO2/0.8) - PaO2

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