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زائر
 |  موضوع: الرئه الصناعيه بالصور والشرح  الثلاثاء نوفمبر 09, 2010 6:06 pm | |
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is an extracorporeal technique of providing both cardiac and respiratory support oxygen to patients whose heart and lungs are so severely diseased or damaged that they can no longer
serve their function
[url=http://www.jordanzane.com/JodanECMO2.jpg] [/url]
Uses
ECMO is most commonly used in neonatal intensive-care units, for newborns in pulmonary distress,but it is also used for adults that, even with the use of a ventilator, need to be oxygenated until they are able to do the job without assistance.
One of the new uses is in adults and children with the H1N1 flu.
It is also used with children who have respiratory syncytial virus infections.
ECMO treatment provides oxygenation until their lung function has sufficiently recovered to maintain appropriate O2 saturation. It is often a last resort.
It is around 75% effective in saving the newborn's life.[citation needed] Newborns cannot be placed on [url=http://www.egynursing.com/vb]ecmo [/url]if they are under 4.5 pounds (2 kg), because they have extremely small vessels for cannulation, thus hindering adequate flow because of limitations from cannula size and subsequent higher resistance to blood flow (compare with vascular resistance).[3] Therefore, the device cannot be used for most premature newborns. Newborn infants are occasionally placed on [url=http://www.egynursing.com/vb]ecmo [/url]due to the lack of a fully functioning respiratory system or other birth defect, but the survival rates drops to roughly 33%.[citation needed]
ECMO has proven to be useful in treating some severe trauma/polytrauma patients.[4]
ECMO use on cadavers can increase the viability rate of transplanted organs
Procedure
ECMO schema
An [url=http://www.egynursing.com/vb]ecmo [/url]machine is similar to a heart-lung machine. To initiate ECMO, cannulae are placed in large blood vessels to provide access to the patient's blood. Anticoagulant drugs, usually heparin, are given to prevent blood clotting. The [url=http://www.egynursing.com/vb]ecmo [/url]machine continuously pumps blood from the patient through a membrane oxygenator that imitates the gas exchange process of the lungs, i.e. it removes carbon dioxide and adds oxygen. Oxygenated blood is then returned to the patient. Management of the [url=http://www.egynursing.com/vb]ecmo [/url]circuit is done by a team of [url=http://www.egynursing.com/vb]ecmo [/url]specialists that includes intensive care unit (ICU) physicians,physician assistants, perfusionists, Registered Nurses,respiratory therapists, and Medical Laboratory Technologists that have received training in this specialty.
Complications
Fatal sepsis may occur when the large catheters inserted in the neck provide fertile field for infection
Additional risks include bleeding. In adults, [url=http://www.egynursing.com/vb]ecmo [/url]survival rates are around 60%, and there are reports of patients being supported for over ten weeks. [url=http://www.egynursing.com/vb]ecmo [/url]has yet to have proven survival benefit in adults with acute respiratory distress syndrome (ARDS). In VA ECMO, patients whose cardiac function does not recover sufficiently to be weaned from [url=http://www.egynursing.com/vb]ecmo [/url]may be bridged to a ventricular assist device (VAD) or transplant.
In infants aged less than 34 weeks of gestation several physiologic systems are not well-developed, specially the cerebral vasculature and germinal matrix, resulting in high sensitivity to slight changes in pH, PaO2, and intracranial pressure. Subsequently, preterm infants are at unacceptably high risk for intraventricular hemorrhage (IVH) if administered [url=http://www.egynursing.com/vb]ecmo [/url]at a gestational age less than 32 weeks. Also later, given the risk of IVH, it has become standard practice to ultrasound the brain prior to administering ECMO.
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عدد المساهمات : 480
تاريخ التسجيل : 22/09/2010
الموقع : فى بيتنا
| | موضوع: رد: الرئه الصناعيه بالصور والشرح الأربعاء نوفمبر 10, 2010 1:40 pm | |
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| | موضوع: رد: الرئه الصناعيه بالصور والشرح الأربعاء نوفمبر 10, 2010 6:47 pm | |
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