Devices and monitoring during neonatal ECMO: survey results

A survey of active ECMO centres regarding neonatal ECMO equipment and personnel was obtained by telephone interview in late summer 1989. Forty-seven of the centres in the USA listed in the Ann Arbor ELSO (Extracorporeal Life Support Organization) Registry at the time ( greater than 90%) were contacted and all participated. Nearly all use a roller pump, while less than 5% use a centrifugal pump. All programmes use a SciMed membrane oxygenator and 90% a SciMed heat exchanger. Heat exchanger water sources include the Gaymar T-pump (42%), Seabrook (25%) and Cincinnati Sub-Zero (23%) units. Eighty-seven per cent use a bladder box servo-regulated to the roller pump; these are most often custom-made (69%) but 13% of programmes use a commercially available (Seabrook) bladder box. Ten per cent use a pressure-regulated roller pump rather than a conventional (displacement) bladder box to detect decreases in venous return. Nearly 80% monitor circuit line pressures between the pump and patient. Seventeen per cent use an air bubble detector on the arterial side of the circuit. Only 10% use an arterial bubble trap and 6% an arterial line filter. Seventy-five per cent do not monitor gas line pressures into the membrane lung, but one-third do use a gas line pop-off valve to prevent elevated gas phase pressures. Seventy per cent reported use of continuous in-line measurement of mixed venous oxygen saturation; no programme reported any blood chemistries being monitored in line.(ABSTRACT TRUNCATED AT 250 WORDS)