Technique
ECMO requires a closed circuit of the oxygenating apparatus with the patient's circulation:
- the oxygenating circuit - pump, membrane lung and heat exchanger - is first primed with matched blood
- venous access is obtained by cannulating the right atrium via the right internal jugular vein; blood is pumped from this site
- oxygenated blood is returned via:
- the right femoral vein in the case of veno-venous bypass
- the common carotid artery in the case of veno-arterial bypass
- anticoagulation is maintained with heparin
- as soon as the patient is stabilised on ECMO, ventilator settings are reduced to rest the lungs
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