TAILIEUCHUNG - Adults - Support to extracorporeal life: Part 2

(BQ) Continued part 1, part 2 of the document Adults - Support to extracorporeal life has contents: Circuits, membranes, and pumps; ventilator management during ECLS, daily care on ECLS, ECMO weaning and decannulation,. and other contents. Invite you to refer. | Chapter 7 Vascular Access for ECLS Steven A. Conrad Introduction Access to the central circulation to provide and maintain blood flow necessary for adequate gas exchange is one of the most essential aspects for successful extracorporeal support. Inadequate extracorporeal flow can lead to failure to deliver sufficient support and limit any potential benefit of ECLS. Cannulae and cannula insertion techniques are quite variable and the choice will depend on the goals and mode of support the size of the patient size of the vessels as well as institutional and logistical concerns. Cannulas for Extracorporeal Support A variety of cannulae for peripheral vascular access are commercially available. These cannulae differ with respect to the mode of insertion percutaneous or surgical blood flow direction drainage or reinfusion and wall reinforcement as well as being available in various lengths and diameters to accommodate the choice of vessel. Cannulae designed for percutaneous peripheral insertion have some minor feature differences from those intended for surgical placement. The loading dilator that accompanies a percutaneous cannula has a long taper and central lumen to accommodate a guidewire whereas the surgical cannula has a blunt dilator with a short tip and no central lumen. The tip of a percutaneous cannula is designed to fit snugly . Conrad MD PhD MCCM FCCP Department of Medicine Emergency Medicine and Pediatrics Louisiana State University Health Sciences Center 1501 Kings Highway Shreveport LA 71103-4228 USA e-mail sconrad@ Springer Science Business Media New York 2016 133 . Schmidt ed. Extracorporeal Life Support for Adults Respiratory Medicine 16 dOi 978-1-4939-3005-0_7 134 . Conrad against the loading dilator and is tapered to facilitate insertion through tissue whereas this feature is optional in surgical cannulas. Wire-reinforced cannulas contain a layer of metal spiral-wound wire embedded in the wall of the cannula. This .

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• Ventilator management during ECLS
• Extracorporeal life support
• The stosry of ECLS
• Mobilization during ECLS
• Crises during ECLS