Reanimate Conference

Hands-On ECMO Training

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Knobology & the Circuit

Simple Circuit = Safe Circuit

 

RPM >> Flow

You set pump RPMs and based on the preload and afterload, you get your flow

Preload Factors

  • Volume (hypovolemia, bleeding)
  • Cannula Diameter (also length, kinking, position)
  • Viscosity (Hb, Temp)

when elevated,

can get cavitation, hemolysis (elevated LDH and plama-free Hb)

Afterload Factors

  • Cannula Diameter (also length, kinking, position)
  • Oxygenator Resistance
  • SVR

Pressures

Pven

Normal -50 to -100

Ppre-Part=Pdelta (dP or delta P)

If Ppre is elevated and Part is normal, there is increased resistance in the oxygenator–? clot

Should be ~ 10 x flow (L) (20-50)

Part

Keep under 100

Heat Exchanger

Microtemp Lt or LSZ Heat Xchanger

 

 

 

Fiber Oxygenator

Gas inside

blood outside

Water inside

 

 

Sechrist Blender

fdO2

Sweep

FiO2

 

Tubing 3/8”

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