The Journal of extra-corporeal technology
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J Extra Corpor Technol · Sep 2009
A 2007 survey of extracorporeal life support members: personnel and equipment.
Extracorporeal membrane oxygenation (ECMO) is used to support patients with cardiopulmonary failure in the intensive care unit. The purpose of this study is to determine what professional qualifications, equipment, and tests are used by established ECMO programs registered with the Extracorporeal Life Support Organization (ELSO). A survey link (Survey-Monkey) was e-mailed to the 110 registered ELSO program coordinators. ⋯ The most common monitoring/safety devices were battery back-up (84%), pre- and post-oxygenator pressure (82%), mixed venous oxygen saturation (80%),venous line pressure (76%), blood flowmeter (63%),bubble detector (61%), point-of-care blood gases (59%), and in-line blood gas monitoring (47%). Laboratory tests available included d-dimer (65%), plasma-free hemoglobin (63%), anti-Xa plasma heparin concentration (43%), thromboelastograph (37%), and heparin concentration using protamine titration (35%). This survey of ELSO-registered centers represents an overview of current ECMO practices.
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J Extra Corpor Technol · Sep 2009
Gaseous microemboli in a pediatric bypass circuit with an unprimed venous line: an in vitro study.
Miniaturizing cardiopulmonary bypass (CPB) circuits to reduce hemodilution and allogenic blood product administration is common in cardiac surgery. One major concern associated with smaller CPB circuits is a possible increase in gaseous microemboli (GME) sent to the cerebral vasculature, which is exacerbated by vacuum-assisted venous drainage (VAVD). The use of VAVD has increased with smaller venous line diameter and venous cannulae. ⋯ Group 2 (57.33 +/- 25.01, p < .05) had significantly more microemboli than group 1 (5.33 +/- 3.21) at the post-oxygenator sensor. No other findings were statistically significant. The results suggest that, if an oxygenator and arterial filter with sufficient air handling capabilities are used, this method to reduce prime volume may not increase GME in the arterial line distal to the arterial filter.