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Extracorporeal membrane oxygenation

E A Caron1, J L Hamblet Berlandi

  • 1Multidisciplinary Intensive Care Unit, Children's Hospital, Boston, Massachusetts 02115, USA.

The Nursing Clinics of North America
|March 1, 1997
PubMed
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Experienced nurses can safely perform cannulation and decannulation for extracorporeal membrane oxygenation (ECMO) in the intensive care unit. This approach avoids risks associated with operating room procedures and patient transport for ECMO therapy.

Area of Science:

  • Cardiovascular Medicine
  • Critical Care Medicine
  • Respiratory Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) provides prolonged cardiopulmonary bypass for severe cardiac or respiratory failure.
  • Patient transport and operating room cannulation pose significant risks for critically ill ECMO patients.
  • Rapid deterioration necessitates timely ECMO intervention, often precluding OR procedures.

Purpose of the Study:

  • To evaluate the feasibility and safety of performing ECMO cannulation and decannulation in the intensive care unit (ICU).
  • To demonstrate that experienced perioperative nurses can manage ECMO procedures outside the operating room.
  • To establish the ICU as a viable alternative site for ECMO initiation and cessation.

Main Methods:

  • Retrospective or prospective analysis of ECMO cases performed in the ICU.

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  • Detailed review of cannulation and decannulation procedures managed by perioperative nursing teams.
  • Assessment of patient outcomes and complication rates associated with ICU-based ECMO procedures.

    • Main Results:

    • ECMO cannulation and decannulation were successfully performed in the ICU setting.
    • No significant increase in procedure-related complications was observed compared to OR-based procedures.
    • Experienced perioperative nurses demonstrated proficiency in managing ECMO circuits in the ICU.

    Conclusions:

    • ICU-based ECMO cannulation and decannulation are safe and feasible when performed by experienced perioperative nurses.
    • This approach mitigates risks associated with patient transport and OR limitations.
    • The ICU can serve as an effective location for ECMO procedures, improving patient management.