BOOK
Extracorporeal Membrane Oxygenation (ECMO), An Issue of Critical Care Clinics, E-Book
Nitin Puri | Michael Baram | Nicholas Cavarocchi
(2017)
Additional Information
Book Details
Abstract
This issue of Critical Care Clinics focuses on Mechanical Circulatory Support. Editors Nitin Puri and Michael Baram have assembled an expert team of authors on topics such as: History of ECMO; Evolution current technique and equipment; Program Development; Review ELSO standards; Cardiac Failure of medical management; Cardiac Management and Complications; Pre-Respiratory; Respiratory Management and Complications; Post ECMO management; Post ECMO complication; DVT; Transport- Interhospital and How to prep patient; ECHO; Family understanding of ECMO (to cannulate or not); Pharmacy, Nutrition, Blood Management; Transport; The future of ECMO and ventilation.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Extracorporeal Membrane Oxygenation\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | vii | ||
| Preface: Extracorporeal Membrane Oxygenation | vii | ||
| Introduction to Extracorporeal Membrane Oxygenation | vii | ||
| Developing an Extracorporeal Membrane Oxygenation Program | vii | ||
| Cardiac Support: Emphasis on Venoarterial ECMO | vii | ||
| Management Strategies for Severe Respiratory Failure: As Extracorporeal Membrane Oxygenation Is Being Considered | vii | ||
| Vascular Complications in Extracorporeal Membrane Oxygenation | viii | ||
| Pediatric Extracorporeal Membrane Oxygenation | viii | ||
| Extracorporeal Membrane Oxygenation Management: Techniques to Liberate from Extracorporeal Membrane Oxygenation and Manage ... | viii | ||
| Issues in the Intensive Care Unit for Patients with Extracorporeal Membrane Oxygenation | ix | ||
| Staffing, Equipment, Monitoring Considerations for Extracorporeal Membrane Oxygenation | ix | ||
| Transport While on Extracorporeal Membrane Oxygenation Support | ix | ||
| Medication Complications in Extracorporeal Membrane Oxygenation | ix | ||
| CRITICAL CARE CLINICS\r \r | x | ||
| FORTHCOMING ISSUES | x | ||
| January 2018 | x | ||
| April 2018 | x | ||
| RECENT ISSUES | x | ||
| July 2017 | x | ||
| April 2017 | x | ||
| January 2017 | x | ||
| Preface:\rExtracorporeal Membrane Oxygenation | xi | ||
| Introduction to Extracorporeal Membrane Oxygenation | 763 | ||
| Key points | 763 | ||
| INTRODUCTION | 763 | ||
| HISTORY | 764 | ||
| PROGRAM EVOLUTION | 764 | ||
| ISSUE STRUCTURE | 765 | ||
| SUMMARY | 766 | ||
| REFERENCES | 766 | ||
| Developing an Extracorporeal Membrane Oxygenation Program | 767 | ||
| Key points | 767 | ||
| INTRODUCTION | 767 | ||
| INSTITUTIONAL COMMITMENT | 768 | ||
| Market Analysis | 768 | ||
| Needs Assessment | 768 | ||
| Program Vision | 768 | ||
| Outreach and Inreach | 769 | ||
| Financial Assessment and Business Plan | 769 | ||
| TECHNOLOGY AND EQUIPMENT | 769 | ||
| Pumps | 770 | ||
| Heater/Cooler | 770 | ||
| Monitors | 770 | ||
| Blood Analyzers | 770 | ||
| Disposables | 771 | ||
| Membrane Oxygenators | 771 | ||
| Cannula | 771 | ||
| Facility Planning | 771 | ||
| TEAM BUILDING/STAFF MODELS | 772 | ||
| Guidelines for Training and Continuous Education of Extracorporeal Membrane Oxygenation Specialists | 772 | ||
| Initial training | 772 | ||
| Continuing education | 773 | ||
| Policies and Protocols | 773 | ||
| Program Evaluation | 774 | ||
| REFERENCES | 774 | ||
| Cardiac Support | 777 | ||
| Key points | 777 | ||
| INTRODUCTION | 777 | ||
| WHAT IS VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION AND HOW DOES IT DIFFER FROM VENOVENOUS EXTRACORPOREAL MEMBRANE OXY ... | 778 | ||
| HOW TO SELECT APPROPRIATE PATIENTS FOR VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION. WHAT ARE THE INDICATIONS AND CONTR ... | 779 | ||
| General Considerations | 779 | ||
| Indications for Venoarterial Extracorporeal Membrane Oxygenation | 780 | ||
| Refractory Cardiogenic Shock | 780 | ||
| Extracorporeal Cardiopulmonary Resuscitation | 781 | ||
| Massive Pulmonary Embolism | 782 | ||
| Accidental Hypothermia | 782 | ||
| Septic Shock | 782 | ||
| Pulmonary Hypertension | 783 | ||
| Additional Indications | 783 | ||
| Contraindications to Venoarterial Extracorporeal Membrane Oxygenation | 783 | ||
| THE DECISION HAS BEEN MADE TO PROCEED WITH EXTRACORPOREAL MEMBRANE OXYGENATION. HOW IS THE OPTIMAL CANNULATION STRATEGY DET ... | 783 | ||
| Central Cannulation | 783 | ||
| Peripheral Cannulation | 784 | ||
| Venous (Inflow) Cannula | 784 | ||
| Arterial (Outflow) Cannula | 784 | ||
| TRIPLE CANNULATION STRATEGIES | 785 | ||
| Venoarteriovenous Extracorporeal Membrane Oxygenation | 785 | ||
| Venovenoarterial Extracorporeal Membrane Oxygenation | 786 | ||
| Additional Therapies | 787 | ||
| How to Manage Patients Who Are Cannulated and on Extracorporeal Membrane Oxygenation Support | 787 | ||
| HEMODYNAMIC SUPPORT | 788 | ||
| Determine the Degree of Support Required | 788 | ||
| Optimize Flow | 788 | ||
| Optimize Mean Arterial Pressure | 788 | ||
| Maintain Pulsatility | 788 | ||
| Ensure Adequate Gas Exchange | 789 | ||
| Extracorporeal Membrane Oxygenation Circuit | 789 | ||
| Ventilator Management | 789 | ||
| Monitoring Adequacy of Perfusion | 790 | ||
| Hemoglobin Concentration | 790 | ||
| Anticoagulation and Bleeding | 791 | ||
| SUMMARY | 791 | ||
| REFERENCES | 791 | ||
| Management Strategies for Severe Respiratory Failure | 795 | ||
| Key points | 795 | ||
| INTRODUCTION | 795 | ||
| INDICATIONS FOR EXTRACORPOREAL MEMBRANE OXYGENATION | 797 | ||
| Acute Respiratory Distress Syndrome | 797 | ||
| Lung Transplantation | 798 | ||
| Miscellaneous | 798 | ||
| APPROACH TO THE VENTILATOR PRE–EXTRACORPOREAL MEMBRANE OXYGENATION | 798 | ||
| Lung-Protective Strategy | 798 | ||
| Airway Pressure Release Ventilation and High-Frequency Oscillatory Ventilation | 799 | ||
| Medical Supportive Therapies | 799 | ||
| Corticosteroids | 799 | ||
| Diuretics | 800 | ||
| Prone-positioning | 800 | ||
| Vasodilators | 801 | ||
| Neuromuscular blockade | 801 | ||
| PLANNING FOR EXTRACORPOREAL MEMBRANE OXYGENATION | 802 | ||
| Assessment of Cardiac Function | 802 | ||
| Assessment for Sepsis | 803 | ||
| Assessment for an Inferior Vena Cava Filter | 803 | ||
| Assessment for Central Nervous System Disease | 803 | ||
| Clarification of Goals of Care | 803 | ||
| SUMMARY | 804 | ||
| REFERENCES | 804 | ||
| Vascular Complications in Extracoporeal Membrane Oxygenation | 813 | ||
| Key points | 813 | ||
| INTRODUCTION | 813 | ||
| PATIENT EVALUATION | 814 | ||
| Vascular Access for Venoarterial Extracorporeal Membrane Oxygenation | 814 | ||
| Cannula Size Selection | 814 | ||
| Vascular Access for Venovenous Extracorporeal Membrane Oxygenation | 815 | ||
| VASCULAR COMPLICATIONS | 817 | ||
| Thromboembolic Complications | 817 | ||
| Clinical manifestations | 817 | ||
| Treatment of ischemic complications | 817 | ||
| Vessel Damage | 820 | ||
| Clinical manifestations | 820 | ||
| Prevention and treatment | 820 | ||
| Infection | 821 | ||
| Clinical manifestations | 821 | ||
| Prevention and treatment of infection | 821 | ||
| SUMMARY | 821 | ||
| REFERENCES | 822 | ||
| Pediatric Extracorporeal Membrane Oxygenation | 825 | ||
| Key points | 825 | ||
| INTRODUCTION | 825 | ||
| EQUIPMENT AND EXTRACORPOREAL MODES | 826 | ||
| Circuit | 826 | ||
| Roller Pumps | 826 | ||
| Centrifugal Pumps | 827 | ||
| Pressure and Flow Monitors | 828 | ||
| Membrane Lungs | 828 | ||
| Modes of Support: Venovenous Support | 829 | ||
| Modes of Support: Venoarterial Support | 830 | ||
| Patient Care | 832 | ||
| INDICATIONS AND CONTRAINDICATIONS | 832 | ||
| VENTILATOR MANAGEMENT | 833 | ||
| PHARMACOLOGY | 833 | ||
| Sedation and Analgesia | 833 | ||
| ANTICOAGULATION MANAGEMENT | 834 | ||
| Anticoagulation | 834 | ||
| Antithrombin III | 834 | ||
| FLUID OVERLOAD AND RENAL DYSFUNCTION | 834 | ||
| WEANING FROM EXTRACORPOREAL SUPPORT | 835 | ||
| NUTRITION | 835 | ||
| HEMOLYSIS AND PLASMAPHERESIS | 836 | ||
| COMPLICATIONS (EXCERPTED FROM THE PEDIATRIC AND NEONATAL PORTION OF THE INTERNATIONAL EXTRACORPOREAL LIFE SUPPORT ORGANIZAT ... | 836 | ||
| Bleeding | 836 | ||
| Cannula site bleeding | 836 | ||
| Surgical site bleeding | 837 | ||
| Gastrointestinal hemorrhage | 837 | ||
| Cardiac tamponade | 837 | ||
| Central nervous system complications | 837 | ||
| Infection | 838 | ||
| Mechanical Complications | 838 | ||
| Premature de-cannulation | 838 | ||
| Membrane lung failure | 838 | ||
| Tubing rupture | 838 | ||
| Pump malfunction | 839 | ||
| OUTCOMES | 839 | ||
| REFERENCES | 839 | ||
| Extracorporeal Membrane Oxygenation Management | 843 | ||
| Key points | 843 | ||
| INTRODUCTION | 843 | ||
| COMPLICATIONS | 844 | ||
| WEANING FROM EXTRACORPOREAL MEMBRANE OXYGENATION | 844 | ||
| Weaning from venovenous–extracorporeal membrane oxygenation | 845 | ||
| Weaning from venoarterial–extracorporeal membrane oxygenation | 845 | ||
| Venoarterial Extracorporeal Membrane Oxygenation Weaning for Cardiogenic Shock | 846 | ||
| POST–EXTRACORPOREAL MEMBRANE OXYGENATION MANAGEMENT | 849 | ||
| Systemic Inflammatory Response Syndrome | 849 | ||
| Post–Extracorporeal Membrane Oxygenation Complications | 849 | ||
| Delirium | 849 | ||
| Posttraumatic Stress Disorder | 850 | ||
| Rehabilitation | 851 | ||
| End-of-Life Issues | 851 | ||
| SUMMARY | 851 | ||
| REFERENCES | 851 | ||
| Issues in the Intensive Care Unit for Patients with Extracorporeal Membrane Oxygenation | 855 | ||
| Key points | 855 | ||
| INTRODUCTION | 855 | ||
| CARDIAC CIRCULATION | 856 | ||
| PULMONARY | 857 | ||
| METABOLIC | 858 | ||
| GASTROINTESTINAL | 858 | ||
| VASCULAR | 858 | ||
| HEMATOLOGY | 858 | ||
| INFECTION | 859 | ||
| NEUROLOGIC | 859 | ||
| INPATIENT TRANSPORT | 860 | ||
| FAMILY INVOLVEMENT | 860 | ||
| REFERENCES | 860 | ||
| Staffing, Equipment, Monitoring Considerations for Extracorporeal Membrane Oxygenation | 863 | ||
| Key points | 863 | ||
| INTRODUCTION | 863 | ||
| Educational Models for Extracorporeal Membrane Oxygenation Specialists | 864 | ||
| Staffing models for extracorporeal membrane oxygenation patients | 866 | ||
| EXTRACORPOREAL MEMBRANE OXYGENATION EQUIPMENT | 867 | ||
| Extracorporeal Membrane Oxygenation Centrifugal Pumps and Pump Consoles | 867 | ||
| Maquet RotaFlow | 867 | ||
| Thoratec CentriMag | 869 | ||
| Maquet CardioHelp | 870 | ||
| Extracorporeal Membrane Oxygenation Oxygenators | 871 | ||
| Extracorporeal Membrane Oxygenation Cannula | 871 | ||
| Dual-Lumen Venovenous Cannula | 872 | ||
| Femoral/Peripheral Cannulas | 873 | ||
| Central Cannulation | 874 | ||
| MONITORING DEVICES FOR EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT | 874 | ||
| Ultrasonic Flow Probes | 874 | ||
| Extracorporeal Membrane Oxygenation Circuit Pressure Monitoring | 874 | ||
| Oxygen Analyzers, Inline Blood Gas Monitoring, and Temperature Monitoring | 875 | ||
| Near-Infrared Spectroscopy | 876 | ||
| The Future: Remote Monitoring and Telemedicine | 879 | ||
| REFERENCES | 879 | ||
| Transport While on Extracorporeal Membrane Oxygenation Support | 883 | ||
| Key points | 883 | ||
| INTRODUCTION | 883 | ||
| EVOLUTION OF TRANSPORT WHILE ON EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT | 885 | ||
| TRANSPORT LOGISTICS WHILE ON EXTRACORPOREAL MEMBRANE OXYGENATION SUPPORT | 885 | ||
| MISSION PLANNING | 887 | ||
| MODE OF TRANSPORT | 887 | ||
| EQUIPMENT | 888 | ||
| TEAM COMPOSITION | 889 | ||
| FLIGHT CONSIDERATIONS | 889 | ||
| Atmospheric Pressure | 889 | ||
| Oxygenation | 890 | ||
| Temperature | 890 | ||
| Noise and Vibration | 890 | ||
| Acceleration and Deceleration Forces | 890 | ||
| Humidity | 891 | ||
| Vision | 891 | ||
| ADVERSE EVENTS | 891 | ||
| SUMMARY | 892 | ||
| REFERENCES | 894 | ||
| Medication Complications in Extracorporeal Membrane Oxygenation | 897 | ||
| Key points | 897 | ||
| INTRODUCTION | 897 | ||
| EXTRACORPOREAL MEMBRANE OXYGENATION AND PHARMACOKINETICS | 898 | ||
| Drug Sequestration | 899 | ||
| Volume of Distribution | 899 | ||
| SEDATIVES/ANALGESICS-OPIOIDS | 901 | ||
| Fentanyl | 901 | ||
| Other Opioids | 907 | ||
| Ketamine | 907 | ||
| Benzodiazepines | 907 | ||
| Propofol and Dexmedetomidine | 908 | ||
| NEUROMUSCULAR BLOCKADE | 908 | ||
| ANTICOAGULATION | 908 | ||
| ANTIBIOTICS | 910 | ||
| Vancomycin | 910 | ||
| Carbapenems | 911 | ||
| Piperacillin/Tazobactam | 911 | ||
| Aminoglycosides | 912 | ||
| Azithromycin | 912 | ||
| Linezolid | 912 | ||
| Tigecycline | 913 | ||
| Oseltamivir | 913 | ||
| Ribavirin | 913 | ||
| ANTIFUNGALS | 913 | ||
| Amphotericin B | 913 | ||
| Echinocandins/Azoles | 914 | ||
| Antituberculosis Agents | 914 | ||
| SUMMARY | 915 | ||
| REFERENCES | 915 |