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This book explores the unique aspects involved in the management of ECMO patients such as physiopathology and indications, setting up the device, monitoring ECMO and the patient, troubleshooting, ethical aspects and rehabilitation. For the past eight years, management of acute heart failure and Acute Respiratory Distress Syndrome (ARDS) patients has been improved by the development of short-term assistance devices, with ECMO as a first line treatment. This highly informative book provides essential insights for ICU nurses at ECMO centers around the world, who face the substantial challenges involved in the management of ECMO patients. Above all, it meets their training needs with regard to bedside monitoring for these patients, which has become a major issue. The editors and most of the contributors serve at La Pitié-Salpétrière ICU, France, which, in terms of the number of admissions and major publications produced, is one of the world’s leading authorities on ECMO.
Extracorporeal Membrane Oxygenation (ECMO) is a procedure that uses a machine to take over the work of the lungs and sometimes the heart. The system provides heart-lung bypass support using a pump to circulate blood through an artificial lung back into the bloodstream, providing enough oxygen to the patient, whilst allowing time for the lungs and heart to rest or heal during or after serious illness. ECMO is often used for babies, but can also be used for children and adults (Medline Plus). The techniques for ECMO require professionals from multidisciplinary background to be involved in the procedure. This practical manual is a comprehensive guide to ECMO. Divided into eleven sections, the book begins with an introduction to the procedure and equipment. The following sections provide step by step discussion on initiation, maintenance of support and monitoring, and techniques of ECMO for different case scenarios. The final sections present multiple choice questions for self assessment and extensive appendices. Key points Comprehensive guide to Extracorporeal Membrane Oxygenation (ECMO) Highly relevant for intensivists, anaesthesiologists, surgeons, paediatricians and cardiologists Includes section of multiple choice questions for self assessment More than 186 full colour images and illustrations
PART I: RRT Section SECTION 1: AKI and Introduction to RRT Introduction to Renal Replacement Therapy 1. Managerial Aspects of Setting Up Renal Replacement Therapy in Intensive Care Unit 2. Acute Kidney Injury: Epidemiology and Causes SECTION 2: RRT: Basic Principles 3. Principles of Renal Replacement Therapy: Practical Applications 4. Types of Renal Replacement Therapy in ICU 5. Indications for Renal Replacement Therapy in ICU: Renal and Nonrenal 6. Initiation of Renal Replacement Therapy SECTION 3: RRT Components 7. RRT Hardware: Cannulas and Dialysis Membranes 8. CRRT: Know the Machine 9. Dialysate Fluids and Replacement Fluids in Continuous Renal Replacement Therapy SECTION 4: Management during RRT 10. Sustained Low-efficiency Extended Daily Dialysis in ICU 11. CRRT Prescription in ICU Patients 12. Anticoagulation in Continuous Renal Replacement Therapy 13. Transportation of Patients Who are on Continuous Renal Replacement Therapy 14. Monitoring during Continuous Renal Replacement Therapy 15. High-volume CRRT 16. Switch Over From or Termination of Continuous Renal Replacement Therapy SECTION 5: Issues during RRT 17. Complications during Renal Replacement Therapy 18. Troubleshooting in Renal Replacement Therapy 19. Nutrition during Renal Replacement Therapy 20. Drug Dosing in Patients Receiving Renal Replacement Therapy SECTION 6: Renal Replacement Therapy: Special Considerations 21. Dyselectrolytemia and Renal Replacement Therapy in Critically Ill Patients 22. Continuous Renal Replacement Therapy in Specific Situations/Diseases 23. Renal Replacement Therapy and Pregnancy 24. Acute Peritoneal Dialysis in ICU 25. Renal Replacement Therapy in Poisonings: Basic Principles 26. Hemoperfusion for the Treatment of Poisoning. 27. Therapeutic Apheresis 28. Extracorporeal Therapies in Sepsis 29. Renal Replacement Therapy in Children 30. Quality Assurance for Renal Replacement Therapy 31. Multiple Choice Questions on Renal Replacement Therapy PART II: ECMO Section SECTION 7: ECMO: Basic Principle Extracorporeal Membrane Oxygenation: Introduction 32. ECMO: Definition, Type, and Variants 33. ECMO Physiology 34. Indications and Contraindications of Extracorporeal Membrane Oxygenation 35. Know the Extracorporeal Membrane Oxygenation Machine: Circuit and Hardware SECTION 8: ECMO Component 36. Cannulation in Extracorporeal Membrane Oxygenation 37. Circuit Priming and ECMO Initiation 38. Extracorporeal Membrane Oxygenation Circuit Diagram SECTION 9: ECMO: Administrative Issues 39. Development of ECMO Program 40. Communication, Consent, and Ethical Issues during ECMO 41. Cost Reduction Strategy during ECMO SECTION 10: Management during ECMO 42. Anticoagulation Management during Extracorporeal Membrane Oxygenation: Heparin and Alternatives 43. Mechanical Ventilation in Patients Undergoing ECMO 44. Managing Pain, Anxiety and Psychological Issues during Extracorporeal Membrane Oxygenation 45. Blood and Component Therapy during ECMO: When and Why? 46. Proning and Mobilization on ECMO 47. Monitoring during Extracorporeal Membrane Oxygenation 48. Procedures during ECMO Emergency and Nonemergency 49. ECMO Weaning, Trial Off, and Decannulation 50. Post Extracorporeal Membrane Oxygenation 51. Extracorporeal Membrane Oxygenation and Sepsis in Intensive Care Unit SECTION 11: Extracorporeal Membrane Oxygenation: Complication 52. Infection Control Issues during Extracorporeal Membrane Oxygenation 53. Managing Complication during Extracorporeal Membrane Oxygenation 54. Managing Left Ventricular Distension during VA ECMO 5...