ECMO-/ECLS

(Marcin) #1

HELPFUL TIPS:



  • Use appropriate size ET tube to prevent (minimize) air leak

  • Hemodynamic stability should be ensured before starting HFOV

  • Infants may need to be sedated on HFOV

  • CXR should be obtained within 30 minutes of starting HFOV for assessing lung
    volume

  • Blood gas should be checked within one hour of starting HFOV to assess for


OTHER
Transcutaneous pCO2 monitoring
 A method of assessing pCO2 without drawing blood
 Where to apply probe?
Patient <1 month old Patient >1 month old
Thorax under clavicle Earlobe
Abdomen Low on forehead
Back Cheek
Low on forehead Thorax under clavicle
Inner or anterior aspect of thigh Upper arm
Behind ear on mastoid process


 When Tc PCO2 doesn’t match blood gas pCO2, consider:
 Site of probe is hypoperfused (e.g. shock, hypothermia, vasoactive drugs)
 Condition of skin and subcutaneous tissue
 Increased cell metabolism (e.g. fever)
 Blood gas analyzer calibration

Free download pdf