Presentation
Patient presented with cardiogenic shock due to viral myocarditis. He had severe shortness of breath, tachycardia, and fever. On examination blood pressure and heart rate were low. VA-ECMO was initiated by pediatric intensivist.
Patient Data
ECMO venous cannula (blue arrow) and ECMO arterial cannula (red arrow). Complete white out of both lungs.
Case Discussion
ECMO, or extracorporeal membrane oxygenation, is a medical treatment that uses a machine to oxygenate a patient's blood outside of their body. Cannulas, or small tubes, are used to connect the patient to the ECMO machine.
There are two types of cannulas used in ECMO: venous and arterial. The venous cannula is inserted into a vein, typically in the neck or chest, and is used to remove deoxygenated blood from the patient. The arterial cannula is inserted into an artery, also typically in the neck or chest, and is used to return oxygenated blood to the patient.
The size and shape of the cannulas used in ECMO can vary depending on the patient and the specific ECMO machine being used. The cannulas are typically made of plastic or silicone and are designed to be as minimally invasive as possible.
One of the key factors in the successful use of ECMO is proper cannula placement. The cannulas must be inserted into the correct blood vessels, and they must be securely fastened to prevent bleeding or dislodgement. Improper cannula placement or movement can cause significant complications, such as bleeding, infection, or injury to the blood vessels or surrounding tissue.
In addition to proper placement, the cannulas must also be properly maintained and cleaned to prevent infection. This includes regular monitoring of the cannulas for signs of infection or malfunction, and prompt replacement or repair as needed.
ECMO is a highly specialized and complex treatment that is typically only used in critically ill patients with severe respiratory or cardiac failure who are not responding to other treatments. It is typically used in the intensive care unit (ICU) and is often used as a last resort in patients who are not responding to other treatments.
Overall, ECMO cannulas play a critical role in the ECMO treatment, the proper placement and maintenance are crucial for the success of the treatment and the well-being of the patient.
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