Ecmo Abstract Extracorporeal Membrane Oxygenation

ECMO Abstract

Extracorporeal Membrane Oxygenation (ECMO) is a heart/lung procedure and support system. The first successful ECMO procedure took place in 1972. Since then, technologies have advanced tremendously. Because ECMO is becoming a more critical component of perioperative care, the formation of qualified nursing staff teams is the responsibility of every healthcare institution.

An ECMO team consists of primary care physicians, nurses, and technicians. Many members of the team should ideally be specialists in cardio-pulmonary medicine or ideally, in ECMO itself. The newborn patient has a higher rate of survival than older children or even adults, which is why ECMO is often indicated for neonates. Parents of newborns needing ECMO need to be aware of what the procedure entails and how long their child might require intervention. Moreover, the quality of the institution's equipment has a strong bearing on the ECMO course of treatment.

The two types of ECMO: venoarterial (VA), and venovenous (VV), are used in different situations. VA in particular supports cardiac circulation by pumping, whereas VV ECMO does not. Using VV ECMO, excess CO2 can also be removed from the patient's blood. ECMO is indicated in patients that have serious but potentially reversible conditions. One way of selecting patients who are appropriate for ECMO is to use the APACHE scoring system.

There are some complications associated with ECMO ranging from infection to GI and cranial bleeding. Nursing and other healthcare staff need to be aware of the complications and how to address them. It is strongly advised that the patient receive 24-hour care and bedside attendance.

The procedure and methods: In one dozen hospitals, all neonates are tested with the APACHE system. The procedure of the study uses APACHE to test patients during a pre-trial period. Those patients that are deemed eligible for ECMO will receive treatment. Nursing staff will attend to all patients 24 hours per day. At the end of the ECMO treatment intervention, the results are tabulated. Complications and side-effects are noted duly.

Results: The results from the population sample show that a large percentage of neonates requiring ECMO are eligible. When the healthcare institution has appropriate ECMO equipment in house, and the staff needed to operate it, then the patient outcomes are higher for those whose healthcare institutions do not support the state of the art equipment or training.