Extracorporeal Membrane Oxygenation in Patients after Cardiac Surgery: Problems and Nursing Care
Keywords:
POSTCARDIOTOMY PATIENTS, EXTRACORPOREAL MEMBRANE OXYGENATION, NURSING CAREAbstract
Extracorporeal membrane oxygenation (ECMO) is an established treatment option for adult patients with refractory cardiogenic shock that provides prolonged yet temporary cardiac and respiratory support. ECMO is a high-risk therapy with potentially adverse effects such as bleeding, stroke, infection, distal limb ischemia, and acute renal failure. Nurses are integral members of the ECMO team whose responsibilities include monitoring for and preventing complications as well as evaluating the patient’s response to the therapy. It is very important for nurses to understand the principles of ECMO, modes of ECMO support, indications and contraindications of ECMO, its complications, and nursing care. The nurses dealing with patients with ECMO should be able to assess the complications correctly and provide the appropriate nursing care when these complications happen. Furthermore, nurses must pay attention to individual needs of the patient’s caregivers and activate all available support systems to help them cope with the stress and strain of providing care to the patients with ECMO.
References
2. Musial R, Ochonska K, Proc A, Stolinski J, Plicner D, Kapelak B, et al. Veno-arterial Extracorporeal membrane oxygenation as cardiogenic shock therapy support in adult patients after heart surgery. Kardiochir Torakochirurqui Pol 2017; 14(1): 32-6.
3. Allen S, Holena D, McCunn M, Kohl B, Sarani B. A review of the fundamental principles and evidence base in the use of extracorporeal membrane oxygenation (ECMO) in critically ill adult patients. J Intensive Care Med 2011; 26(1): 13-26.
4. Homvises B. Extracorporeal membrane oxygenation (ECMO). Clinic 2016; 32(3): 218-227. (in Thai).
5. Mosier JM, Kelsey M, Raz Y, Gunnerson KJ, Meyer R, Hypes CD, et al. Extracorporeal Membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions. Crit Care 2015; 19(431): 1-8.
6. Evans R. Post-partum spontaneous coronary artery dissection and the use of veno-arterial extra-corporeal membrane oxygenation. Nurs Crit Care 2014; 19(6): 304-9.
7. Aubron C, DePuydt J, Belon F, Bailey M, Schmidt M, Sheldrake J, et al. Predictive factors of bleeding events in adults undergoing extracorporeal membrane oxygenation. Ann Intensive Care 2016; 6(97): 1-10.
8. Mateen FJ, Muralidharan R, Shinohara RT, Parisi JE, Schears GJ, Wijdicks EF. Neurological injury in adults treated with extracorporeal membrane oxygenation. Arch Neurol 2011; 68(12): 1543-9.
9. Cheng R, Hachamovitch R, Kittleson M, Patel J, Arabia F, Moriguchi J, Esmailian F, Azarbal B. Complications of extracorporeal membrane oxygenation for treatment of cardiogenic shock and cardiac arrest: a meta-analysis of 1,866 adult patients. Ann Thorac Surg 2014; 97(2): 610-6.
10. Mehta A, Ibsen LM. Neurologic complications and neurodevelopmental outcome with extracorporeal life support. World J Crit Care Med 2013; 2(4): 40-7.
11. Biffi S, Di Bella S, Scaravilli V, Peri AM, Grasselli G, Alagna L, et al. Infections during extracorporeal membrane oxygenation: epidemiology, risk factors, pathogenesis and prevention. Int J Antimicro Agents 2017, 50(1): 9-12.
12. Wang JG, Han J, Jia YX, Zeng W, Hou XT, Meng X. Outcome of veno-arterial extracorporeal membrane oxygenation for patients undergoing valvular surgery. PLoS ONE [Internet]. 2013 [cited 2017 Sep 17]; 8(5). Available from: https://www.ncbi.nlm.nih.gov/pubmed/.
13. Gander JW, Fisher JC, Reichstein AR, Gross ER, Aspelund G, Middlesworth W, et al. Limb ischemia after common femoral artery cannulation for venoarterial extracorporeal membrane oxygenation: an unsolved problem. J Pediatr Surg 2010; 45(11): 2136-40.
14. Khorsandi M, Dougherty S, Bouamra O, Pai V, Curry P, Tsui S, et al. Extra-corporeal membrane oxygenation for refractory cardiogenic shock after adult cardiac surgery: a systematic review and meta-analysis. J Cardiothorac Surg [Internet]. 2017 [cited 2017 Sep 17]; 12(1). Available from: https://www.ncbi.nlm.nih.gov/pubmed/.
15. Villa G, Katz N, Ronco C. Extracorporeal membrane oxygenation and the kidney. Cardiorenal Med 2015; 6(1): 50-60.
16. Chinnoros S, Norasan S. Nursing care for surgical patients IV. 1st ed. Bangkok: Ramthai Press; 2010. p. 39-40. (in Thai).
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