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PedsCrit

VV ECMO Part 3: Troubleshooting the circuit & preparing for early rehab

May 8, 2023
Guest Jenna Miller, Associate Professor of Pediatrics, discusses troubleshooting the VV-ECMO circuit and preparing for early rehab. Topics include nutrition for patients on VV-ECMO, moving towards early extubation and mobilization, breastfeeding and feeding on ECMO, waking up patients on ECMO, and early rehabilitation and sedation approach for pediatric patients.
28:08

Episode guests

Podcast summary created with Snipd AI

Quick takeaways

  • Monitoring circuit variables is crucial for optimal VV ECMO performance, including FIO2, sweep rates, and pressure in different components.
  • Dehydration and bleeding can impact circuit pressures, while recirculation and CO2 levels should be carefully managed in VV ECMO patients.

Deep dives

Understanding Circuit Variables in VV ECMO

In VV ECMO, monitoring circuit variables is crucial for maintaining stable gas exchange. These variables include the FIO2 and sweep rates. FIO2, which ranges from 0.5 to 100%, should be set below 100% to avoid taxing the oxygenator. Sweep rates, ranging from 0.5 to 10, impact ventilation defect, with higher rates indicating worse ventilation. Additionally, pressure monitoring in different components of the circuit, such as inlet pressure, pressure after the pump, and pressure after the oxygenator, is essential for troubleshooting and assessing oxygenator health. Changes in pressures can indicate factors like cannula size, hydration status, and oxygenator resistance to flow. Keeping a close eye on these circuit variables can help ensure optimal ECMO performance.

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