Daily monitoring: Blood gas analysis after membrane
Posted: Sun Feb 02, 2025 8:45 am
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.
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.