What is venoarterial pediatric ECMO?

Updated: Dec 21, 2017
  • Author: Edwin Rodriguez-Cruz, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Answer

The standard ECMO procedure used in most neonatal ICUs is venoarterial bypass. In this situation, a cannula is placed through the right jugular vein into the right atrium. Blood is drained to a venous reservoir located 3-4 feet below heart level. The blood is actively pumped by a roller pump through the oxygenator, where gas exchange occurs via countercurrent flow of blood and gas. Next, the blood is warmed to body temperature by the heat exchanger before returning to the patient through a cannula placed through the right carotid artery into the aortic arch. Systemic anticoagulation therapy with heparin is administered throughout the bypass circuit, with frequent monitoring of activated clotting time (ACT), which should be maintained at 180-240 seconds.


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