Daily monitoring: Blood gas analysis after membrane

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Prone position ventilation (PPV) care

Before changing the position, secure the tube position and check all connections to reduce the risk of disconnection. Change the patient's position every 2 hours.

1 ECMO equipment should be operated by ECMO perfusionists and the following aspects should be checked and recorded hourly: Flow/pump speed; Blood flow; Oxygen flow; Oxygen concentration; Ensuring that the temperature controller is working; Temperature set point and actual temperature; No clots in the circuit; No pressure on the cannula or kinks in the tubing, or no “shaking” of the ECMO tubing; Patient urine color with particular attention to red or dark brown urine; Pre- and post-membrane japan number data pressure as requested by the physician.

2 The following items should be monitored and recorded during each shift: Check cannula depth and fixation to ensure secure ECMO circuit connections, temperature regulator water level line, machine power source and oxygen connection, cannula site for bleeding and swelling; measure leg circumference and check for swelling of the lower limb on the surgical side; check lower extremities, i.e. dorsalis pedis pulse, skin temperature, color,
etc.

4 Anticoagulant therapy: The main goal of anticoagulant therapy for ECMO is to achieve a moderate anticoagulant effect that provides a certain coagulation activity under conditions that avoid excessive activation of coagulation. That is, to maintain a balance between anticoagulation, coagulation and fibrinolysis. Patients should be given sodium heparin (25-50 IU/kg) during intubation and maintained with sodium heparin (7.5-20 IU/kg/h) during pump operation. The dosage of sodium heparin should be adjusted according to the results of the APTT test, which should be performed within 40-60 seconds. During the anticoagulation period, the number of skin punctures should be minimized. Surgeries should be performed carefully. The bleeding status should be closely monitored.