ECMO介绍台大医院文件材料教学稿件.ppt

ECMO Introduction 台大醫院 外科加護病房 柯文哲 醫師 ECMO Introduction Dr. Wen-Je Ko SICU, Department of Surgery National Taiwan University Hospital ECMO vs CPB Veneous reservoir CPB vs ECMO ECMO Short-term cardiopulmonary support Buy time to decide the next step Recovery Transplantation long-term device (ventricular assist device) Operation (CABG, pulmonary embolectomy,..) Give-up for lung 1. support : O2 supply CO2 removal 2. rest : reduce ventilator induced lung injury VV-ECMO indication : for lung disease only purpose : to decrease barotrauma ( to prevent ventilator-induced lung injury) ventilator setting : PC mode, PEEP 10 , PIP 35 , VR -- PaCO2, FiO2-- PaO2 VA-ECMO advantage : 1. both lung heart support 2. higher PaO2 An Example of MCS ECMO VAD HTx Different patients Different situations  Different treatments Indications of ECMO in the near future As a mechanical circulatory support: Post-cardiotomy cardiogenic shock Double bridge (ECMO VAD HTx) Acute myocarditis AMI cardiogenic shock (ECPR) Replace CPB: Lung transplantation Neurosurgery Non-heart-beating-donor support Rescue for acute pulmonary embolism Ventilatory support ARDS Neonatal pulmonary diseases