This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Faulkner, S. C Articles by Drummond-Webb, J. J Search for Related Content PubMed PubMed Citation Articles by Faulkner, S. C Articles by Drummond-Webb, J. J Social Bookmarking                         What's this?

Hemodynamic troubleshooting for mechanical malfunction of the extracorporeal membrane oxygenation systems using the PPP triad of variables

Arkansas Children’s Hospital, Little Rock, AR, Department of Pediatric Perfusion, University of Arkansas for Medical Sciences, Little Rock, AR

Charles E Johnson

Arkansas Children’s Hospital, Little Rock, AR, Department of Pediatric Perfusion, University of Arkansas for Medical Sciences, Little Rock, AR

Juan L Tucker

Arkansas Children’s Hospital, Little Rock, AR, Department of Pediatric Perfusion, University of Arkansas for Medical Sciences, Little Rock, AR

Michael L Schmitz

Arkansas Children’s Hospital, Little Rock, AR, Section of Pediatric Cardiovascular Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR

James W Fasules

Arkansas Children’s Hospital, Little Rock, AR, Section of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, AR

Jonathan J Drummond-Webb

Arkansas Children’s Hospital, Little Rock, AR, Section of Pediatric and Congenital Heart Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, drummond-webbjonathan{at}uams.edu

Prolonged usage of disposable extracorporeal membrane oxygenation (ECMO) circuitry increases the risk of mechanical complications due to breakdown or malposition of the circuit elements. Often, such complications are life threatening for the critically ill patient. Such problems need to be rapidly identified and corrected. Algorithms can be especially helpful in such acute, life-threatening situations. We have outlined an algorithm that uses the relationship between three hemodynamic variables that can be used to rapidly identify mechanical dysfunctions associated with use of the ECMO circuit. These hemodynamic variables are premembrane pressure, pump flow, and patient mean systemic arterial pressure (the PPP triad). These variables are interrelated as a change in one variable results in a change in another. Mechanical malfunction can eliminate this relationship. Changes in one variable only suggest mechanical impairment or failure of the ECMO system. When such a change is detected, a checklist can be rapidly reviewed that directs an immediate logical assessment of potential mechanical causes of hemodynamic compromise.

Perfusion, Vol. 18, No. 5, 295-298 (2003)
DOI: 10.1191/0267659103pf679oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?