14. On ECMO

That is pretty fucked up!


Femoro-femoral ECMO if veno-venous.


Start ECMO with 1 lpm, then go upto 4 lpm.
More than 4 lpm causes recirculation (tip-to-tip distance <10cm)


Diffusion type plasma tight oxygenators for ECMO (if not - plasma leakage).


If ECMO is initiated immediately after bypass heparin is usually not given for 12 hours, then begin with infusion of 400 UI/hr or 10 UI/kg/hr up to APPT=60-80 sec.