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1、ECMO Introduction,Dr.Wen-Je KoSICU,Department of SurgeryNational Taiwan University Hospital,ECMO,extracorporeal membrane oxygenation(體外膜氧合器)(艾克膜)(體外維生系統),ECMO,extracorporeal membrane oxygenation(Extracorporeal Life Support),ECMO prolonged partial cardiopulmonary bypass,ECMO vs CPB,Veneous reservoir,
2、CPB vs ECMO,ECMO,Short-term cardiopulmonary supportBuy time to decide the next stepRecoveryTransplantationlong-term device(ventricular assist device)Operation(CABG,pulmonary embolectomy,.)Give-up,for lung,1.support:O2 supply&CO2 removal2.rest:reduce ventilator induced lung injury,for heart,support:i
3、mprove systemic perfusion rest:catecholamine myocardial workdecrease preload requirement and congestion,ECMO Type,VV-ECMOVA-ECMO,VV-ECMO,indication:for lung disease onlypurpose:to decrease barotrauma(to prevent ventilator-induced lung injury)ventilator setting:PC mode,PEEP 10,PIP PaCO2,FiO2-PaO2,VA-
4、ECMO,advantage:1.both lung&heart support 2.higher PaO2,An Example of MCS,ECMO,VAD,HTx,Different patientsDifferent situations Different treatments,Indications of ECMO in the near future,As a mechanical circulatory support:Post-cardiotomy cardiogenic shockDouble bridge(ECMO VAD HTx)Acute myocarditisAMI cardiogenic shock(ECPR)Replace CPB:Lung transplantationNeurosurgeryNon-heart-beating-donor supportRescue for acute pulmonary embolismVentilatory supportARDSNeonatal pulmonary diseases,
