Improving ECMO therapy: Monitoring oxygenator functionality and identifying key indicators, factors, and considerations for changeout
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Le résumé fourni par la source
INTRODUCTION: The optimal timing for extracorporeal membrane oxygenation (ECMO) circuit change-out is crucial for the successful management of patients with severe cardiopulmonary failure. This comprehensive review examines the various factors that influence the timing of oxygenator replacement in the ECMO circuit. By considering these factors, clinicians can make informed decisions to ensure timely and effective change-out, enhancing patient outcomes and optimizing the delivery of ECMO therapy. METHODOLOGY: A thorough search of relevant studies on ECMO circuits and oxygenator change-out was conducted using multiple scholarly databases and relevant keywords. Studies published between 2017 and 2023 were included, resulting in 40 studies that met the inclusion criteria. DISCUSSION: Thrombosis within the membrane oxygenator and its impact on dysfunction were identified as significant contributors, highlighting the importance of monitoring coagulation parameters and gas exchange. Several factors, including fibrinogen levels, pre and post-membrane blood gases, plasma-free hemoglobin, D-dimers, platelet function, flows and pressures, and anticoagulation strategy, were found to be important considerations when determining the need for an oxygenator or circuit change-out. The involvement of a multidisciplinary team and thorough preparation were also highlighted as crucial aspects of this process. CONCLUSION: In conclusion, managing circuit change-outs in ECMO therapy requires considering factors such as fibrinogen levels, blood gases, plasma-free hemoglobin, D-dimers, platelet function, flows, pressures, and anticoagulation strategy. Monitoring these parameters allows for early detection of issues, timely interventions, and optimized ECMO therapy. Standardized protocols, personalized anticoagulation approaches, and non-invasive monitoring techniques can improve the safety and effectiveness of circuit change-outs. Further research and collaboration are needed to advance ECMO management and enhance patient outcomes.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Improving ECMO therapy: Monitoring oxygenator functionality and identifying key indicators, factors, and considerations for changeout
- Date Crossref
- 01/03/2024
- Éditeur
- EDP Sciences
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Cleveland Clinic Perfusion Department pays non établi dans la noticeÉtablissement de santé
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Emirates Foundation pays non établi dans la noticeInstitution
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All India Institute of Medical Sciences Rishikesh pays non établi dans la noticeOrganisme public
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Glenfield Hospital pays non établi dans la noticeÉtablissement de santé
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Perfusion Solution (United States) pays non établi dans la noticeEntreprise
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Ministry of Health pays non établi dans la noticeOrganisme public
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Heart Vascular and Thoracic Institute Perfusionist & ECMO Specialist pays non établi dans la noticeStructure de recherche
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Clinical Perfusionist pays non établi dans la noticeÉtablissement de santé
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Consultant of Cardiovascular Critical Care pays non établi dans la noticeInstitution
Perfusion Department — Cleveland Clinic, Emirates Foundation et All India Institute of Medical Sciences Rishikesh, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.