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1、ECMO Introduction,Dr. Wen-Je Ko SICU, Department of Surgery National 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 re
2、servoir,CPB vs ECMO,ECMO,Short-term cardiopulmonary support Buy time to decide the next step Recovery Transplantation long-term device (ventricular assist device) Operation (CABG, pulmonary embolectomy,) Give-up,for lung,1. support : O2 supply & CO2 removal 2. rest : reduce ventilator induced lung i
3、njury,for heart,support : improve systemic perfusion rest : catecholamine myocardial work decrease preload requirement and congestion,ECMO Type,VV - ECMO VA - ECMO,VV-ECMO,indication : for lung disease only purpose : to decrease barotrauma ( to prevent ventilator-induced lung injury) ventilator sett
4、ing : PC mode, PEEP 10 , PIP PaCO2, FiO2 PaO2,VA-ECMO,advantage : 1. both lung & heart support 2. higher PaO2,An Example of MCS,ECMO,VAD,HTx,Different patients Different situations Different treatments,Indications of ECMO in the near future,As a mechanical circulatory support: Post-cardiotomy cardiogenic shock Double bridge (ECMO VAD HTx) Acute myocarditis AMI cardiogenic shock (ECPR) Replace CPB: Lung transplantation Neurosurgery Non-heart-beating-donor support Rescue for acute pulmonary embolism Ventilatory support ARDS Neonatal pulmonary diseases,