scholarly journals Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplant: Considerations for Critical Care Nursing Practice

2020 ◽  
Vol 40 (3) ◽  
pp. 49-57
Author(s):  
Brittany Koons ◽  
Jennifer Siebert
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Lung Transplant ◽  
Quality Care ◽  
Critical Care Nurses ◽  
Critical Care Nursing ◽  
Membrane Oxygenation ◽  
Transplant Patients ◽  
High Acuity

Topic Candidates waiting for lung transplant are sicker now than ever before. Extracorporeal membrane oxygenation has become useful as a bridge to lung transplant for these critically ill patients. Clinical Relevance Critical care nurses must be prepared to care for the increasing number of lung transplant patients who require this advanced support method. Purpose of Paper To provide critical care nurses with the foundational knowledge essential for delivering quality care to this high-acuity transplant patient population. Content Covered This review describes the types of extracorporeal membrane oxygenation (venovenous and venoarterial), provides an overview of the indications and contraindications for extracorporeal membrane oxygenation, and discusses the role of clinical bedside nurses in the treatment of patients requiring extracorporeal membrane oxygenation as a bridge to lung transplant.

Curriculum to Introduce Critical Care Nurses to Extracorporeal Membrane Oxygenation

2020 ◽  
Vol 29 (4) ◽  
pp. 262-269
Author(s):  
Whitney D. Gannon ◽  
Lynne Craig ◽  
Lindsey Netzel ◽  
Carmen Mauldin ◽  
Ashley Troutt ◽  
...  
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Reference Group ◽  
High Volume ◽  
Critical Care Nurses ◽  
Care Nurse ◽  
Membrane Oxygenation ◽  
Written Examination ◽  
Advanced User ◽  
Before And After

Background Despite the growing use of extracorporeal membrane oxygenation (ECMO) in intensive care units (ICUs), no standardized ECMO training pathways are available for ECMO-naive critical care nurses. Objectives To evaluate a critical care nurse ECMO curriculum that may be reproducible across institutions. Methods An ECMO curriculum consisting of a basic safety course and an advanced user course was designed for critical care nurses. Courses incorporated didactic and simulation components, written knowledge examinations, and electronic modules. Differences in examination scores before and after each course for the overall cohort and for participants from each ICU type were analyzed with t tests or nonparametric equality-of-medians tests. Differences in postcourse scores across ICU types were examined with multiple linear regression. Results Critical care nurses new to ECMO (n = 301) from various ICU types participated in the basic safety course; 107 nurses also participated in the advanced user course. Examination scores improved after completion of both courses for overall cohorts (P < .001 in all analyses). Median (interquartile range) individual score improvements were 23.1% (15.4%-38.5%) for the basic safety course and 8.4% (0%-16.7%) for the advanced user course. Postcourse written examination scores stratified by ICU type, compared with the medical ICU/cardiovascular ICU group (reference group), differed only in the neurovascular ICU group for the basic safety course (percent score difference, −3.0; 95% CI, −5.3 to −0.8; P = .01). Conclusions Implementation of an ECMO curriculum for a high volume of critical care nurses is feasible and effective.

scholarly journals Management of Extracorporeal Membrane Oxygenation for Obstetric Patients: Concerns for Critical Care Nurses

2019 ◽  
Vol 39 (2) ◽  
pp. e8-e15
Author(s):  
Jody Knisley ◽  
Erin DeBruyn ◽  
Michelle Weaver
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Critical Care Nurses ◽  
Her Family ◽  
Obstetric Patient ◽  
Membrane Oxygenation ◽  
Physical Changes

Critical care nurses are faced with many challenges, and one that is particularly stressful is caring for obstetric patients. This care can become more complex when the obstetric patient requires extracorporeal membrane oxygenation. It is imperative that critical care nurses have knowledge about this unique population, the expected physical changes of pregnancy, and the management of extracorporeal membrane oxygenation. Obstetric patients present unique challenges, and care is focused on the woman and her family. The purpose of this paper is to provide information for critical care nurses regarding care of obstetric patients who receive extracorporeal membrane oxygenation.

scholarly journals Extracorporeal membrane oxygenation 2016: an update

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 750 ◽  
Author(s):  
Warwick Butt ◽  
Graeme MacLaren
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Critical Care Nurses ◽  
Membrane Oxygenation ◽  
Recent Trends ◽  
Timing Of Initiation ◽  
Novel Applications

The use of extracorporeal membrane oxygenation (ECMO) is an important issue for intensivists, critical care nurses, surgeons, cardiologists, and many others. There has been a continued increase in the number of centres performing ECMO. This review examines novel applications and recent trends in the use of ECMO over the last 2 years. These include ECMO to facilitate the safe use of other treatments, changing the timing of initiation, newer equipment and better biocompatibility, and the ability of ECMO programs to essentially choose which cluster of potential complications they are prepared to accept. ECMO continues to evolve, diversify in its applications, and improve in safety.

Evolving Role of Anesthesiology Intensivists in Cardiothoracic Critical Care

2020 ◽  
Vol 133 (5) ◽  
pp. 1120-1126 ◽  
Author(s):  
Kenneth T. Shelton ◽  
Jeanine P. Wiener-Kronish
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Cardiogenic Shock ◽  
The Past ◽  
Membrane Oxygenation ◽  
Cardiac Critical Care

The role of cardiothoracic anesthesiology intensivists has expanded over the past few decades. Cardiothoracic anesthesiology intensivists are taking on larger roles in cardiac critical care specializing in cardiogenic shock and extracorporeal membrane oxygenation.

scholarly journals Complicações relacionadas à oxigenação por membrana extracorpórea

2018 ◽  
Vol 12 (6) ◽  
pp. 1727 ◽  
Author(s):  
Gislaine Rodrigues Nakasato ◽  
Juliana Lima Lopes ◽  
Camila Takao Lopes
Keyword(s):  
Critical Care ◽  
Extracorporeal Membrane Oxygenation ◽  
Nursing Care ◽  
Critical Care Nursing ◽  
Eligibility Criteria ◽  
Level Of Evidence ◽  
Membrane Oxygenation ◽  
Renal Vascular ◽  
Care Nursing ◽  
Length Of Hospitalization

RESUMOObjetivo: identificar na literatura as complicações associadas à oxigenação por membrana extracorpórea (ECMO) em adultos. Método: estudo bibliográfico, tipo revisão integrativa de artigos publicados de 2011 a 2016 em português, inglês ou espanhol, nas bases de dados Medline e CINAHL utilizando-se termos padronizados (MeSH e títulos CINAHL). Os títulos, resumos e textos na íntegra dos artigos encontrados foram lidos para aplicação dos critérios de elegibilidade e classificação do nível de evidência. As complicações da ECMO foram agrupadas em hemorrágicas, infecciosas, renais, vasculares, mecânicas, neurológicas e outras. Resultados: foram encontrados 666 estudos, dos quais 45 foram incluídos. As principais complicações identificadas foram: as hemorrágicas, encontradas em 747 indivíduos (21,23%), seguidas das infecciosas (10,85%), renais (9,18%), vasculares (5,99%), mecânicas (4,15%) e neurológicas (3,8%) Conclusão: identificaram-se as principais complicações da ECMO em pacientes adultos. Conhecê-las subsidia o planejamento do cuidado prestado, podendo evitá-las ou diagnosticá-las precocemente, diminuindo assim, a morbimortalidade, custos e tempo de internação. Descritores: Adulto; Cardiologia; Cuidados Críticos; Cuidados de Enfermagem; Oxigenação por Membrana Extracorpórea; Pneumologia.ABSTRACTObjective: to identify the complications associated with extracorporeal membrane oxygenation (ECMO) in adults, as described in the literature. Methods: An integrative review including articles published from 2011 to 2016, in Portuguese, English or Spanish, using standardized terms (MeSH and CINAHL titles) in the Medline and CINAHL databases. The complete titles, abstracts and texts of the articles meeting eligibility criteria were read and classified, based on the level of evidence. The complications of ECMO were grouped into: hemorrhagic, infectious, renal, vascular, mechanical, neurological, and other. Results: Six hundred sixty-six studies were found, of which 45 were included. The main complications identified were: hemorrhagic, in 747 individuals (21.23%), followed by infectious (10.85%), renal (9.18%), vascular (5.99%), mechanical (15%), and neurological (3.8%). Conclusion: The main complications of ECMO in adult patients were identified. The knowledge about them supports planning of care, avoiding complications and, thus, reducing morbidity and mortality, costs, and length of hospitalization. Descriptors: Adult; Cardiology; Critical Care; Nursing care; Extracorporeal membrane oxygenation; Pneumology.RESUMENObjetivo: identificar en la literatura las complicaciones de la oxigenación de membrana extracorpórea (ECMO) en adultos. Método: estudio bibliográfico de revisión integradora con artículos publicados desde 2011 hasta 2016 en portugués, inglés o español, en MEDLINE y CINAHL utilizando términos estandarizados (MeSH y CINAHL). Se leyeron Los títulos, resúmenes y textos en su totalidad de los artículos encontrados para aplicación de los criterios de elegibilidad y clasificación del nivel de evidencia. Se agruparon las complicaciones de la ECMO en hemorrágicas, infecciosas, renales, vasculares, mecánicas, neurológicas y otras. Resultados: se encontraron 666 estudios, de los cuales se incluyeron 45. Las principales complicaciones identificadas fueron: las hemorrágicas, encontradas en 747 individuos (21,23%), seguidas de las infecciosas (10,85%), renales (9,18%), vasculares (5,99%), mecánicas (4, 15%) y neurológicas (3,8%). Conclusión: se identificaron las principales complicaciones de la ECMO en pacientes adultos. Conocerlas subsidia la planificación del cuidado prestado, pudiendo evitarlas o diagnosticarlas precozmente, disminuyendo así, la morbimortalidad, costos y tiempo de internación. Descriptores: Adulto; Cardiología; Cuidados Críticos; Atención de Enfermería; Oxigenación por Membrana Extracorpórea; Neumología.

Nursing Management of a Patient With COVID-19 Receiving ECMO: A Case Report

2021 ◽  
pp. e1-e10
Author(s):  
Nestor Neil A. Peig ◽  
Erica Djen ◽  
Marielle Garalza ◽  
Caroline Given ◽  
Jasmine Henderson ◽  
...  
Keyword(s):  
Critical Care ◽  
Acute Respiratory Distress Syndrome ◽  
Case Report ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Critical Care Nurses ◽  
Nursing Management ◽  
Membrane Oxygenation ◽  
Venovenous Extracorporeal Membrane Oxygenation

Introduction Venovenous extracorporeal membrane oxygenation has been recommended as an effective rescue therapy for select critically ill patients with COVID-19. This case report describes a first experience caring for a patient with COVID-19 who received venovenous extracorporeal membrane oxygenation and expands the literature by discussing relevant nursing management and operational considerations. Clinical Findings A 46-year-old man presented to a hospital emergency department with pleuritic chest pain, dyspnea, anorexia, and chills. The patient was intubated for pneumonia-associated acute respiratory distress syndrome. Diagnosis A nasopharyngeal swab specimen was positive for SARS-CoV-2, and chest radiography confirmed a diagnosis of COVID-19 with acute respiratory distress syndrome. Interventions After no improvement with mechanical ventilation and prone positioning, the patient began receiving venovenous extracorporeal membrane oxygenation and was transferred to an extracorporeal membrane oxygenation center. Frontline critical care nurses played a vital role in coordinating patient care activities, monitoring changes in the patient’s condition, and detecting complications early. Outcomes The patient was decannulated on day 15 and extubated on day 17. The patient was successfully discharged home on hospital day 24. Conclusion Caring for a patient with COVID-19 receiving venovenous extracorporeal membrane oxygenation posed unprecedented challenges that required deviations from standards of care to optimize infection control measures and staff safety while providing quality care. This case report may inform, prepare, and guide other critical care nurses who will be caring for similar patients during this pandemic.

Sign in / Sign up

Export Citation Format

Share Document