TEST - Book of PDFs-01_Keller_Part 1 - Steven Keller_CMS PC.pptx

01_Keller_Part 1 - Steven Keller_CMS PC.pptx - 1

Pdf Summary

This document discusses the use of venovenous ECMO (extracorporeal membrane oxygenation) in managing respiratory failure in adults. The document includes information on the components of ECMO and the physiological basis of extracorporeal support in respiratory failure. It also addresses the challenges of identifying appropriate patients, managing circuit recirculation, and the role of beta-blockers in treating high cardiac output states. The document further discusses how to manage sedation and drug dosing during the initiation and discontinuation of ECMO, as well as different approaches to wean ECMO support.<br /><br />The document presents a case study of a 27-year-old male sous chef who presented with symptoms such as fatigue, dyspnea, chest discomfort, and easy bruising. The patient was eventually diagnosed with acute myelomonocytic leukemia, and his condition rapidly deteriorated, leading to the initiation of ECMO support.<br /><br />The document provides an overview of the physiology of ECMO and its application in patients with severe pulmonary disease and impaired gas exchange. It discusses the recommended indications for venovenous ECMO in adult patients, such as hypoxic and hypercarbic respiratory failure, severe air leak syndromes, lung transplant patients, and acute respiratory collapse.<br /><br />The document also explains the key components of ECMO systems, including the oxygenator, pump, controller, and cannula. It discusses the management of ECMO devices, including parameters such as sweep gas flow rate, pump rotation speed, and cannula size and placement.<br /><br />The document concludes with a discussion on the challenges and unanswered questions surrounding the use of ECMO, including the lack of a validated system to identify patients who will benefit from ECMO over traditional therapy.<br /><br />Overall, this document provides a comprehensive overview of venovenous ECMO and its role in managing respiratory failure in adults.

Keywords

venovenous ECMO

respiratory failure

adults

extracorporeal membrane oxygenation

components of ECMO

physiological basis

circuit recirculation

beta-blockers

sedation and drug dosing

wean ECMO support