Document Detail

Hemodynamic troubleshooting for mechanical malfunction of the extracorporeal membrane oxygenation systems using the PPP triad of variables.
MedLine Citation:
PMID:  14604246     Owner:  NLM     Status:  MEDLINE    
Prolonged usage of disposable extracorporeal membrane oxygenation (ECMO) circuitry increases the risk of mechanical complications due to breakdown or malposition of the circuit elements. Often, such complications are life threatening for the critically ill patient. Such problems need to be rapidly identified and corrected. Algorithms can be especially helpful in such acute, life-threatening situations. We have outlined an algorithm that uses the relationship between three hemodynamic variables that can be used to rapidly identify mechanical dysfunctions associated with use of the ECMO circuit. These hemodynamic variables are premembrane pressure, pump flow, and patient mean systemic arterial pressure (the PPP triad). These variables are interrelated as a change in one variable results in a change in another. Mechanical malfunction can eliminate this relationship. Changes in one variable only suggest mechanical impairment or failure of the ECMO system. When such a change is detected, a checklist can be rapidly reviewed that directs an immediate logical assessment of potential mechanical causes of hemodynamic compromise.
Sherry C Faulkner; Charles E Johnson; Juan L Tucker; Michael L Schmitz; James W Fasules; Jonathan J Drummond-Webb
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Perfusion     Volume:  18     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-11-07     Completed Date:  2004-07-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  295-8     Citation Subset:  IM    
Arkansas Children's Hospital, Little Rock, AR 72202-3591, USA.
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MeSH Terms
Blood Pressure
Equipment Failure Analysis
Extracorporeal Membrane Oxygenation / instrumentation*
Heart-Assist Devices
Oxygenators, Membrane*

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