Recognition of Shock

Aug 22, 2023 by in CRITICAL CARE Comments Off on Recognition of Shock

Now we are going to bring our discussion of shock to the next level and start to explore some patterns that can help us with recognition of shock. Remember, if…

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Membrane Characteristics

Aug 5, 2023 by in CRITICAL CARE Comments Off on Membrane Characteristics

Let’s now turn our attention to the membrane itself. We will explore the function of the membrane oxygenator, its limits, and how we can appraise and assess this function at…

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Anticoagulation and Bleeding Management

Aug 5, 2023 by in CRITICAL CARE Comments Off on Anticoagulation and Bleeding Management

When I am consenting a family for extracorporeal membrane oxygenation (ECMO) and discussing the risks and benefits to initiating ­support, bleeding and clotting are the most common risks that are…

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Pharmacokinetics

Aug 5, 2023 by in CRITICAL CARE Comments Off on Pharmacokinetics

Next time you are reviewing the chart for your patient, take a look at the medication administration record. Every entry represents a decision – a decision to alter the physiology…

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Sweep Gas Flow Titration

Aug 5, 2023 by in CRITICAL CARE Comments Off on Sweep Gas Flow Titration

Adjustments to sweep gas flow are probably the most common adjustments that you will make in the course of an extracorporeal membrane oxygenation (ECMO) run. While it is entirely feasible…

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Ventilator Management on ECMO

Aug 5, 2023 by in CRITICAL CARE Comments Off on Ventilator Management on ECMO

By this point you have probably developed a healthy skepticism for the ventilator. While remaining an undeniable cornerstone in the support of critically ill patients, we have gone into the…

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Blood Flow Titration

Aug 5, 2023 by in CRITICAL CARE Comments Off on Blood Flow Titration

Imagine that you are initiating a patient on extracorporeal membrane oxygenation (ECMO). The cannulas are in excellent position and the circuit is connected and ready to go. You release the…

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Physiology of Retrograde Flow

Aug 5, 2023 by in CRITICAL CARE Comments Off on Physiology of Retrograde Flow

There is nothing intuitive about retrograde flow. You are pumping blood in one direction into the arterial system, which is the opposite direction that blood is supposed to flow. At…

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Central Veno-Arterial ECMO Physiology

Aug 5, 2023 by in CRITICAL CARE Comments Off on Central Veno-Arterial ECMO Physiology

We will now continue our exploration of VA ECMO physiology by considering the physiology of centrally cannulated VA ECMO. The proportion of central cannulation is largely facility dependent. While some…

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