EDECMO Podcast EDECMO 30 – Post-Arrest ECMO Critical Care Management with Deirdre Murphy
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Sep 9, 2016 Deirdre Murphy, a critical care expert at Alford Hospital, dives into the intricacies of post-arrest ECMO management. She emphasizes monitoring vital metrics like oxygen saturation and end tidal CO2 for optimal recovery. The conversation shifts to volume status management, detailing fluid balance complexities. Deirdre also discusses ventilation strategies, underscoring the importance of adjusting CO2 levels and managing anticoagulation. The chat wraps up with a holistic view on care post-ECPR, stressing the need for a comprehensive approach to patient recovery.
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Right Arm Monitoring Essential
- Place a right arm radial arterial line and sats monitor to track brain and coronary oxygenation.
- This prevents missing differential hypoxemia affecting critical organs.
Safe Central Line Insertion
- Turn the pump down briefly during central line insertion to reduce negative pressure.
- Prefer internal jugular site avoiding femoral and subclavian due to anticoagulation risks.
Optimize ECMO Flow and Heart Pulsatility
- Accept ECMO flow limited by cannula size; prioritize distal perfusion cannula placement for limb protection.
- Encourage native heart pulsatility with low-dose inotropes to avoid complications.
