ECMO Specialist Training Manual 3rd Edition

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Table of Contents

1. The History of Extracorporeal Life Support
     Adult Respiratory Failure
     Pediatric Respiratory Failure
     Cardiac Failure
2. Neonatal Pulmonary Physiology and Pathophysiology
     Objectives
     Introduction
     Development of Lung Maturity
     Fetal Circulation
     Neonatal Diseases Treated with ECMO
3. Pathophysiology of Pediatric Cardiac Disease relevant to ECMO
     Objectives
     Introduction
     Single Ventricle Physiology
     Neonate With Univentricle, Parallel Circulation (Unrepaired or Palliated)
     Hypoplastic Left Heart Sydrome
     Bidirectional Glenn Circulation & Fontan Circulations
     Right Ventricular Outflow Obstruction
     Left Ventricular Outflow Tract Obstruction
     Left to Right Shunts (Volume Loaded LV)
     Total Anomalous Pulmonary Venous Drainage (TAPVD)
4. Pediatric Pulmonary Physiology and Pathophysiology
     Objectives
     Introduction
     Inclusion and Exclusion Guidelines
     Pathophysiology
     Editorial
5. Extracorporeal Life Support (ECLS) Physiology
     Objectives
     Introduction
     Native Gas Exchange
     Membrane Lung Gas Exchange
     Pathophysiology of Membrane Lungs
     Oxygen Kinetics and Tissue Respiration
     Hemodynamics
     Summary
     Editorial
6. Extracorporeal Membrane Oxygenation Cannulation and Decannulation
     Objectives
     Venoarterial Extracorporeal Membrane Oxygenationâ€"Cannulation
     Techniqueâ€"Preparation for Cannulation
     Venovenous Extracorporeal Membrane Oxygenationâ€"Cannulation
     Cannulation Technique
     Placing Patient on the Extracorporeal Membrane Oxygenation Circuit
     Extracorporeal Membrane Oxygenationâ€"Decannulation
7. Principles and Practice of Venovenous and Venoarterial ECMO
     Objectives
     Introduction
     VA and VV ECMO: Advantages and Disadvantages
     Circulatory Effects of ECMO
     Oxygenation During ECMO
     Patient Selection
     Cannulation Techniques
     Initiation Of Bypass
     Blood Prime
     Management of ECMO Blood Flow
     Weaning and Trialing Off ECMO
     Decannulation
     Summary
8. ECMO Equipment and Devices
     Objectives
     Introduction
     General principles of ECMO systems
     Cannulas
     Compliance chambers
     The ECMO blood pump
     Oxygenators
     The ECMO Bridge
     Heat Exchange and ECMO Heaters
     ECMO Safety and Monitoring Devices
     Thromboelastography (TEG)
     Surface Coatings
9. ECMO Mechanical Complications
     Objectives
     Introduction
     The ECMO Specialist
     The ECMO Circuit Check
     Basic Emergency Management
     Thrombosis
     Air Embolism
     Membrane Oxygenator Failure
     Tubing Rupture
     Cannula Problems
     Equipment Failure
     Miscellaneous Circuit Components
10. Management of Anticoagulation and Blood Products during ECMO
     Objectives
     Introduction
     Activation of the Coagulation System
     Heparin Management
     Clinical Consequences
     Novel Anticoagulation
11. Management of the Neonate on ECMO
     Objectives
     Introduction
     Inclusion and Exclusion Criteria
     Neonatal Diseases
     The ECMO Team
     ECMO Initiation
     Cannulation
     Daily Patient Management
     ECMO Weaning
     Conclusion
12. Management of the Pediatric ECMO Patient
     Objectives
     Introduction
     Common Pediatric Diagnosis
     Pediatric ECMO Respiratory Selection Guidelines
     Cardiac and Septic Shock ECMO Selection Guidelines
     Common Pediatric ECMO Exclusion Guidelines
     Patient Management Guidelines
     Special Considerations for the Pediatric ECMO Patient
     Apheresis Utilizing the ECMO Circuit
     Special Considerations for Clinical Care
     Blood Product Administration
     Packed Red Blood Cells (PRBCs)
     Fresh Frozen Plasma (FFP)
     Platelets
     Cryoprecipitate
     Protocol for Platelet and Cryoprecipatate Administration
     Amicar®
     Editorial
     Competencies
13. Management of the Cardiac ECMO Patient
     Objectives
     Introduction
     Cardiac ECMO Indications
     Cardiac Versus Pulmonary ECMO
     Daily Management of the Cardiac ECMO Patient
     Complications
     Weaning from ECMO
     Appendix: Outcomes in Cardiac ECMO
14. Adult Extracorporeal Life Support
     Objectives
     Introduction
     ECLS for Respiratory Failure
     Cardiac Support
     Conclusion
15. Medical and Surgical Management of the CDH Patient on ECMO
     Objectives
     Introduction
     Indications for ECMO
     Exclusion Criteria
     Management on ECMO â€" What the ECMO Specialist Should Know
     CDH Outcome
     Summary
16. Extracorporeal Life Support during Cardiac Arrest (ECPR)
     Objectives
     Introduction
     If you decide to do ECPR
     Post Cannulation Care
     Advantages and Disadvantages
     Outcome
     Summary
17. Hemofiltration and Hemodialysis on ECMO
     Objectives
     Background
     Introduction
     Hemofiltration versus hemodialysis
     Equipment
     Pros and Cons of Setup Options
     Coagulation Management Differences
     Management Goals
     Other Indications for Hemofiltration and Hemodiafiltration
18. Plasmapheresis for the ECMO Patient
     Objectives
     Introduction
     Selected Indications for Plasmapheresis
     Principles of Therapeutic Plasma Exchange (TPE) Operation
     Specific Apheresis Considerations for the ECMO Circuit
     Specific humoral considerations of Therapeutic Apheresis
     Cardiorespiratory, Metabolic and Hematalogic Considerations
     Cardiorespiratory Considerations
     Metabolic Considerations
     Hematologic Considerations
     Circuit Priming
     Anticoagulation Issues
     Patient Care of ECMO TPE Patient
     Complications
     Apheresis Specialist Training and Competencies
     Planned maintenance, calibration testing and Procedure for equipment failur
19. Cooling Neonates for Cerebral Protection on ECMO
     Objectives
     Introduction
     Editorial
20. Responsibilities of the ECMO Specialists and RN Staff
     Objectives
     Introduction
     Responsibilities of the ECMO Specialist and the Nursing Staff
21. ECMO Intra-Hospital Transport: Minimizing Risk
     Objectives
     Introduction
     Background
     Methodology
     Preparation and Equipment
     Transport
     Conclusions and Recomendations
22. Outcome After Neonatal ECMO
     Objectives
23. Outcome Following Pediatric ECMO
     Objectives
     Introduction
24. Case Scenarios - Neonatal, Cardiac, ECPR, Adult, Pediatric
     Objectives
     Introduction
     Neonatal Case Scenario
     Cardiac Case Scenario
     ECPR Patient Case Scenario
     Adult Respiratory Failure Patient Case Scenario
     Pediatric Respiratory Failure Case Scenario
25. Trouble Shooting: The What-If's of ECMO
     Objectives
     Introduction: