Where are ECMO catheters placed?

The most commonly sites for percutaneous cannulation for establishing peripheral ECMO are femoral artery, femoral vein or internal jugular vein. In central ECMO right atrium and aorta are the preferred vessels. There are two separate configurations of ECMO circuit: veno-venous (VV) and veno-arterial (VA).

How is an ECMO machine placed?

The ECMO machine works by inserting a plastic tube into a large vein and/or artery through the neck, chest or groin of the patient. This tube allows for the patient’s blood to flow out into an oxygenator, or artificial lung.

What is North South Syndrome on ECMO?

Introduction. Harlequin syndrome, also known as “North–South Syndrome” or “Dual Circulation,” occurs when there is an area of watershed within the aorta where the ECMO oxygenated blood from the femoral artery meets the low oxygenated blood from the impaired lungs, during peripheral VA-ECMO.

What size are ECMO cannulas?

Cannulation. Our standard femoral cannulation for va-ECMO included a 15 or 17 Fr arterial cannula (length 15 cm) and a 21 or 23 Fr venous cannula (length 55). Cannulas for vv-ECMO were 17 or 19 Fr (length 15 cm) in size for inflow, and 21 or 23 Fr (length 38 cm) in size for outflow.

What is the difference between an ECMO machine and a ventilator?

How does ECMO differ from a ventilator? A ventilator moves air in and out of the lungs when you are unable to get enough oxygen on your own. An ECMO machine circulates your blood through a machine to exchange carbon dioxide and deliver oxygen.

What is the difference between ECMO and bypass?

Differences between ECMO and cardiopulmonary bypass: ECMO is frequently instituted using only cervical cannulation, which can be performed under local anesthesia whereas standard cardiopulmonary bypass is usually instituted by transthoracic cannulation under general anesthesia (Figure 8).

What is Harlequin syndrome ECMO?

Conclusion: Harlequin syndrome is a known complication of peripheral VA-ECMO, where the upper part of the body is poorly oxygenated. It occurs when the native heart function is preserved but the lungs are poorly functioning. Therapeutic options include converting to central VA-ECMO or VA-V-ECMO.

What is the sweep on ECMO?

Sweep is the setting that controls how much CO2 the ECMO machine removes from the blood. Our system has 2 dials that control sweep; one for larger adjustments and one for fine-tuning. Right next to the sweep control is the oxygen mixer, which controls the FiO2.

What are the 4 types of ECMO?

There are two types of ECMO. Venoarterial (VA) ECMO can be used for heart and lung support, while venovenous (VV) ECMO is used for lung support only. The ECMO team will decide which type will help your loved one the most, based on his or her specific illness.