TEST - Book of PDFs-01_Keller_Part 1 - Steven Keller

01_Keller_Part 1 - Steven Keller_CMS PC.pptx

Pdf Summary

This document is a summary of a session discussing venovenous Extracorporeal Membrane Oxygenation (ECMO) and its management in adult patients with respiratory failure. The session was conducted by three medical professionals and focused on topics such as the components of ECMO, patient selection, managing circuit recirculation, the role of beta-blockers, sedation and drug dosing, and approaches to weaning ECMO support.<br /><br />The session began with a case presentation of a 27-year-old male sous chef with complaints of fatigue, dyspnea, chest discomfort, and other symptoms. His condition was eventually diagnosed as acute myelomonocytic leukemia and he required ECMO support due to worsening hypoxia and the onset of acute respiratory distress syndrome (ARDS).<br /><br />Venovenous ECMO is used to support patients with severe pulmonary disease and impaired gas exchange. It involves removing blood from the venous system, pumping it through a gas-exchange device, and then returning it to the venous system. The session discussed the recommended indications for VV ECMO in adult patients, such as hypoxic respiratory failure and severe air leak syndromes.<br /><br />The ECMO system consists of an oxygenator, pump, controller, and cannula. These components are managed based on parameters such as sweep gas flow rate, pump rotation speed, volume management, and cannula size and placement.<br /><br />The session also addressed the challenges of using ECMO, such as sedation, inactivity, and ventilator-associated lung injury. The session highlighted the lack of a validated system to identify patients who will benefit from ECMO over traditional therapy.<br /><br />In conclusion, the session emphasized the importance of understanding the physiological basis of ECMO and patient-circuit interactions for proper patient selection. It also discussed the evaluation of ECMO as an experimental therapy and the potential benefits it can provide compared to standard therapy.

Keywords

venovenous ECMO

Extracorporeal Membrane Oxygenation

respiratory failure

adult patients

ECMO management

circuit recirculation

beta-blockers

sedation

drug dosing

weaning ECMO support