• | To understand the design of a basic veno-venous ECMO circuit. |
• | To become familiarized with the basic controls of an ECMO system. |
• | To become familiarized with the basic behaviour of a centrifugal pump. |
PaO2 | 45 mm Hg |
PaCO2 | 44 mm Hg |
pH | 7.3 |
BXS | - 3.5 |
Temp | 37.0 |
SaO2 | 74% |
Click the <Investigations> <TG SAX> in the <Inspector> window. |
Click the <Display> button in the <Patient Monitor> window. |
Check <ECG>, <Direct Arterial Pressure>, <Central Venous Pressure> and <SaO2> in the <Display> window. |
Click the <Display> button in the <Patient Monitor> window. |
Click the <Devices><Ventilator> menu item in the <Inspector> window. |
Turn the ventilator on by clicking the power switch at the top right-hand side of the device. Set the tidal volume (Vt) to 500 mls, the rate to 12 bpm, the FiO2 to 100% and the PEEP to 5 cms H2O. |
Click <Bolus Drug><Pancuronium (2mg/ml)>in the <Therapeutic Interface> window. |
Drag the green slider until it says ~ 8 mgs and click the <Give> button. |
Click the <Devices><Nerve Stimulator> menu item in the <Inspector> window. |
Click the <TOF> button on the nerve stimulator itself. |
Click the <Display> button in the <Patient Monitor> window. |
Check < Capnography > and < Gases > in the <Display> window. |
Click the <Display> button in the <Patient Monitor> window. |
Click <Investigations><Arterial Blood Gas Analysis> in the <Inspector> window. |
Click <Bolus Drug><Pancuronium (2mg/ml)>in the <Therapeutic Interface> window. |
Drag the green slider until it says ~ 8 mgs and click the <Give> button. |
Click the <Devices><Nerve Stimulator> menu item in the <Inspector> window. |
Click the <TOF> button on the nerve stimulator itself. |
• | Given the patient 7500 units of heparin (Select <Heparin> from the <Therapeutic Interface> <Bolus Drug> page and <Give> 7500 units) and |
• | Positioned the cannulae under ultrasonic control. |
Click <Devices> <ECMO System> in the <Inspector> window. |
• | Circuit pressure measured at a point between the pump head and the oxygenator, |
• | Pump speed in rpm, |
• | Blood Temperature. |
• | The main power switch enables the flow control knob which is situated just beneath it. |
• | The flow control is used to adjust the speed of the centrifugal pump in the range 0 – 5000 rpm. |
• | The <Adjust Cannula> button allows you to move the drainage cannula(e) in or out and to select size of your return cannula. |
• | Finally, the <Mode> button is used to set the system up for either VV or VA ECMO. |
Select <Devices><ACT Monitor> and click <Start> in order to commence the measurement. |
Click the power switch of the ECMO system and slowly rotate the flow control clockwise. |
Click <Investigations><Arterial Blood Gas Analysis>in the <Inspector> window. |
Click <Devices> <ECMO System> in the <Inspector> window. |
Click the <Timer> button in the <Patient Monitor> window. |
• | The SaO2 is higher. |