-- Glossary of Terms --

Coming Off ECMO and Beyond
Introduction
 

ECMO Glossary - Common Words & Phrases

ACT -Activated Clotting Time: a test that measures how many seconds it takes for the blood to clot.
 
Acute Respiratory Distress Syndrome (ARDS):A condition in which the lungs are damaged and do not appropriately allow oxygen into the blood.
 
Antibiotic:A drug that kills bacteria or germs. Used to prevent or cure an infection.
 
Aorta:The large artery that carries oxygenated (red) blood from the heart to the body.
 
Artery:This is the type of blood vessel that pumps red (oxygen rich) blood to the body's organs.
 
Bronchoscopy (bronk-os-co-pee):A procedure to visualize and examine the lungs with a fiber optic camera. Samples of tissue and sputum may be sent to the laboratory for testing.
 
Cannulas:The plastic tubes that are placed in the blood vessels by the surgeons to drain blood from the body to the ECMO circuit, and back again.
 
Cannulation:The process of placing the cannulas into the blood vessels. This process may be performed surgically (incision made) or percutaneously (through the skin much like an IV).
 
Carbon dioxide (CO2):This gas is one of the body's waste products that is expelled through exhaling or breathing out.
 
Cardiac catheterization:A procedure where a small catheter is placed into a vein or artery that is threaded up to the heart to allow us to look at the function of the heart under x-ray.
 
Cardiac ECHO:Ultrasound that allows us to look at the function of the heart.
 
Cardiology:Specializing in the care of patients with heart disease.
 
Cardiovascular (CV) surgeon:A doctor specializing in vein, artery, and heart surgery.
 
Carotid artery:The large artery in the neck that carries blood from the heart to the brain.
 
Centrifugal pump:The "artificial heart" in the ECMO machine. A device that pumps the blood through the ECMO circuit and then returns it back to the patient.
 
Chest tube:A tube that is placed through the chest wall into the space between the lung and chest wall to drain air or fluid. Used to treat a collapsed lung (pneumothorax) or to drain fluid.
 
Chest X-ray:An X-ray performed to look at the lungs and heart.
 
CHD or Congenital Heart Defect:Many different types of heart defects exist. If your loved one is on ECMO because of a heart problem, you will be given more information by the Cardiology service.
 
Clamped off:A trial period when your loved one is taken off ECMO before the cannulas are removed (de-cannulation).
 
CT Scan:a sophisticated X-ray, usually of the brain, that allows us to look for bleeding or other problems.
 
Decannulation:The process of removing the cannulas from the blood vessels. This process may be performed at the bedside in the intensive care unit.
 
Dobhoff tube:This is a tube that is inserted through the nose to a part of the intestines (duodenum). May also be called an NJ (nasojejunal) tube. This tube allows us to give nutrition and calories to the patient.
 
ECLS:Extracorporeal Life Support. Another name for ECMO.
 
ECMO:Stands for "Extracorporeal Membrane Oxygenation". The process by which blood is removed from the body, enters a circuit of tubing where carbon dioxide is removed and oxygen is added, is re-warmed and then pumped back into the body. This supports the body with oxygenated blood in place of the patient's own heart and lungs.
 
ECMO Flow:measure of how much blood is being pumped through the circuit to support the patient.
 
ECMO team:The team consists of specialized surgeons, perfusionists, physicians, nurses, and respiratory therapists.
 
EEG (Electroencephalogram):A tracing of the electrical activity of the brain. Electrodes (wires) are placed on the scalp in several locations.
 
Endotracheal tube:A tube that is placed directly in the mouth leading into the lungs to help breathe and protect the patient's airway.
 
Heat Exchanger:A machine that is connected to the membrane oxygenator that warms the blood before it is pumped back to the patient.
 
Heparin:A drug that thins the blood and prevents it from clotting.
 
Hemofiltration:An artificial kidney that may be used to remove extra fluid that the patient's own kidneys can't remove. It is inserted into the ECMO circuit.
 
Interstitial Lung Disease:Scarring of the lungs that make it difficult for enough oxygen to get into the blood stream.
 
Intracranial or intraventricular hemorrhage (IVH):Abnormal bleeding in or around the brain. This is a dangerous potential complication of ECMO. It can be seen on ultrasound or on a CT scan.
 
Ligation of blood vessels:When the ECMO catheters are removed, the veins and/or artery they were in are often permanently ligated (closed off with a stitch). Usually, this does not cause any problems because the blood can take an alternate route.
 
Membrane Oxygenator:A membrane that removes carbon dioxide from the blood and replaces it with oxygen. This is also known as the "artificial lung."
 
MRI:A test that uses magnetic fields to image the brain or other body parts.
 
Neonatologist:A physician specializing in the care of newborn babies, including those who are critically ill.
 
Nephrology:The study of kidney function.
 
Neurology:The part of medicine that specializes in the nervous system, which includes the brain and spinal cord.
 
Platelets:Small particles in the blood that help in the clotting ability of our body.
 
Pneumothorax:Escape of air from the lung into the space between the lung and chest wall.
 
Pulmonary hypertension:A condition characterized by higher than normal blood pressure in the arteries of the lungs. The high pressure is caused by the lumen (central hollow port) of the arteries narrowing. As a result, the heart works harder to pump blood through the lungs because the blood vessels won't "open up" and let the blood pass through. This may cause the heart to fail or the blood to take another route around the lungs. If blood cannot flow normally through the lungs, it is difficult for it to pick up needed oxygen. When blood does not contain sufficient oxygen, other body organs will start to fail. This condition can be fatal. Sometimes, pulmonary hypertension can be cured. ECMO is sometimes used to provide oxygen to the organs while taking the strain off the lungs and/or heart. This may allow the arteries in the lung to relax and open up.
 
Radiologist:A doctor who specializes in reading x-rays and sonograms.
 
Respiratory Distress:Trouble breathing.
 
Sepsis:An infection in the blood.
 
Status Asthmaticus:An asthma attack that does not get better with usual treatments and causes patients to have difficulty getting enough air in and out of their lungs.
 
Surfactant:A soap-like substance normally found in the lungs of full-term babies, children and adults. This substance keeps the lungs from collapsing. Premature babies may not have enough of this to keep their lungs from collapsing.
 
Tracheostomy:tube that is placed directly into the neck that leads to the lungs. This tube takes the place of the endotracheal tube that is placed in the mouth. The tracheostomy tube helps to protect the larynx. It also decreases the risk of infecting the lungs with germs from the mouth.
 
Transplant Rejection:When the immune system of a patient with a transplanted organ recognizes that the organ is "foreign" and tries to attack the organ damage.
 
Trialing off (Weaning):period when ECMO support is temporarily stopped or slowed down to evaluate the function of the heart and/or lungs. If improvement is shown, ECMO may be discontinued.
 
Urgent ECLS/E-CPR:An emergency ECMO system. It is generally used for patients who are extremely unstable and may be close to a cardiac arrest.
 
VA ECMO:(veno-arterial ECMO). A type of ECMO that drains blood from a vein, oxygenates the blood in the circuit, and returns the blood to the body through an artery. This type of ECMO can be used to support both the heart and lungs.
 
VV ECMO:(veno-venous ECMO). A type of ECMO that drains blood from a vein, oxygenates the blood in the circuit, and returns the blood through a vein. This type of ECMO is used when only the lungs need support.
 
Ventilator:A breathing machine that delivers oxygen, pressure and a rate of breathing to the patient through a breathing (endotracheal) tube. Also known as a respirator or vent.
 
Ventricular Assist Device (VAD):This is a device that will assist the left side of the heart while a patient is waiting for a heart transplant. More information will be given to you if your family member is waiting for this device.
 
Weaning:The process by which the amount of support is slowly decreased as the patient gets better. The term may be used to refer to the blood flow rate of the ECMO machine or the settings of the ventilator.

-- Glossary of Terms --

Coming Off ECMO and Beyond
Introduction