An overview on the anatomy of the spine
Cervical spine The cervical spine is composed of seven vertebrae, with the first two vertebrae known as the atlas (C1) and axis (C2). The atlas contains a thick anterior arch…
Anticoagulation and Bleeding Management
When I am consenting a family for extracorporeal membrane oxygenation (ECMO) and discussing the risks and benefits to initiating support, bleeding and clotting are the most common risks that are…
Membrane Characteristics
Let’s now turn our attention to the membrane itself. We will explore the function of the membrane oxygenator, its limits, and how we can appraise and assess this function at…
Pharmacokinetics
Next time you are reviewing the chart for your patient, take a look at the medication administration record. Every entry represents a decision – a decision to alter the physiology…
Sweep Gas Flow Titration
Adjustments to sweep gas flow are probably the most common adjustments that you will make in the course of an extracorporeal membrane oxygenation (ECMO) run. While it is entirely feasible…
Ventilator Management on ECMO
By this point you have probably developed a healthy skepticism for the ventilator. While remaining an undeniable cornerstone in the support of critically ill patients, we have gone into the…
Blood Flow Titration
Imagine that you are initiating a patient on extracorporeal membrane oxygenation (ECMO). The cannulas are in excellent position and the circuit is connected and ready to go. You release the…
Physiology of Retrograde Flow
There is nothing intuitive about retrograde flow. You are pumping blood in one direction into the arterial system, which is the opposite direction that blood is supposed to flow. At…
Central Veno-Arterial ECMO Physiology
We will now continue our exploration of VA ECMO physiology by considering the physiology of centrally cannulated VA ECMO. The proportion of central cannulation is largely facility dependent. While some…
Introduction to ECMO Management Principles
Hopefully by this point, you are starting to develop a much better sense of the principles at play when someone is on extracorporeal membrane oxygenation (ECMO). We started with the…
