Emergency treatment of centrifugal pump dysfunction in extracorporeal membrane oxygenation
10.3760/cma.j.cn121430-20220126-00100
- VernacularTitle:体外膜肺氧合过程中离心泵失功的应急处理
- Author:
Ke FANG
1
;
Jun WANG
;
Ruixiang SUN
;
Peng ZHANG
;
Qiancheng XU
;
Yang LI
;
Haijiao JIANG
;
Xiaogan JIANG
Author Information
1. 皖南医学院第一附属医院（弋矶山医院），重症医学科/安徽省危重症呼吸疾病临床医学研究 中心，安徽芜湖 241000
- Keywords:
Extracorporeal membrane oxygenation;
Centrifugal pump dysfunction;
Low blood flow;
Mechanical complications
- From:
Chinese Critical Care Medicine
2022;34(10):1088-1091
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the treatment process of rapid decrease in blood flow due to centrifugal pump dysfunction during extracorporeal membrane oxygenation (ECMO) and its related thinking.Methods:On September 25, 2021, the ECMO treatment of a 14-year-old boy with severe mycoplasma pneumonia, severe viral pneumonia and acute respiratory distress syndrome (ARDS) admitted to the department of critical care medicine of the First Affiliated Hospital of Wannan Medical College was analyzed.Results:Oxygenation of the child was difficult to maintain under invasive mechanical ventilation, and lung consolidation progressed seriously. After evaluation, venous-venous ECMO (VV-ECMO) was implemented, then oxygenation was improved. In the 120th hour after VV-ECMO establishment, the blood flow sudden decreased, the speed was 3 822 r/min, while the flow was only 0.2 L/min, more over there was no change in the flow when the speed was increased. Before that, the ECMO speed was 3 530 r/min, and the flow was up to 3.4 L/min and stable. After rapid screening, it was determined that the centrifugal pump was dysfunction. ECMO was successfully replaced and the flow was satisfactory.Conclusions:At present, most ECMO centers do not routinely monitor the pressure before and after the pump. There is a lack of visual and quantitative techniques or indicators to judge the pump's function, and there is also a lack of corresponding clinical experience in treatment. This paper summarizes the investigation and treatment process of ECMO pump dysfunction of this case to provide reference.
