Table of Contents

1. The History of Extracorporeal Life Support

Adult Respiratory Failure
Pediatric Respiratory Failure
Cardiac Failure
2. Neonatal Pulmonary Physiology and Pathophysiology
Objectives
Introduction
Development of Lung Maturity
Fetal Circulation
Neonatal Diseases Treated with ECMO
3. Pathophysiology of Pediatric Cardiac Disease relevant to ECMO
Objectives
Introduction
Single Ventricle Physiology
Neonate With Univentricle, Parallel Circulation (Unrepaired or Palliated)
Hypoplastic Left Heart Sydrome
Bidirectional Glenn Circulation & Fontan Circulations
Right Ventricular Outflow Obstruction
Left Ventricular Outflow Tract Obstruction
Left to Right Shunts (Volume Loaded LV)
Total Anomalous Pulmonary Venous Drainage (TAPVD)
4. Pediatric Pulmonary Physiology and Pathophysiology
Objectives
Introduction
Inclusion and Exclusion Guidelines
Pathophysiology
Editorial
5. Extracorporeal Life Support (ECLS) Physiology
Objectives
Introduction
 Native Gas Exchange
Membrane Lung Gas Exchange
Pathophysiology of Membrane Lungs
Oxygen Kinetics and Tissue Respiration
Hemodynamics
Summary
Editorial
6. Extracorporeal Membrane Oxygenation Cannulation and Decannulation
Objectives
Venoarterial Extracorporeal Membrane Oxygenationâ€"Cannulation
Techniqueâ€"Preparation for Cannulation
Venovenous Extracorporeal Membrane Oxygenationâ€"Cannulation
Cannulation Technique
Placing Patient on the Extracorporeal Membrane Oxygenation Circuit
Extracorporeal Membrane Oxygenationâ€"Decannulation
7. Principles and Practice of Venovenous and Venoarterial ECMO
Objectives
Introduction
VA and VV ECMO: Advantages and Disadvantages
Circulatory Effects of ECMO
Oxygenation During ECMO
Patient Selection
Cannulation Techniques
Initiation Of Bypass
Blood Prime
Management of ECMO Blood Flow
Weaning and Trialing Off ECMO
Decannulation
Summary
8. ECMO Equipment and Devices
Objectives
Introduction
General principles of ECMO systems
 Cannulas
Compliance chambers
The ECMO blood pump
Oxygenators
The ECMO Bridge
Heat Exchange and ECMO Heaters
ECMO Safety and Monitoring Devices
Thromboelastography (TEG)
Surface Coatings
9. ECMO Mechanical Complications
Objectives
Introduction
The ECMO Specialist
The ECMO Circuit Check
Basic Emergency Management
Thrombosis
Air Embolism
Membrane Oxygenator Failure
Tubing Rupture
Cannula Problems
Equipment Failure
Miscellaneous Circuit Components
10. Management of Anticoagulation and Blood Products during ECMO
Objectives
Introduction
Activation of the Coagulation System
Heparin Management
Clinical Consequences
Novel Anticoagulation
11. Management of the Neonate on ECMO
Objectives
Introduction
Inclusion and Exclusion Criteria
 Neonatal Diseases
The ECMO Team
ECMO Initiation
Cannulation
Daily Patient Management
ECMO Weaning
Conclusion
12. Management of the Pediatric ECMO Patient
Objectives
Introduction
Common Pediatric Diagnosis
Pediatric ECMO Respiratory Selection Guidelines
Cardiac and Septic Shock ECMO Selection Guidelines
Common Pediatric ECMO Exclusion Guidelines
Patient Management Guidelines
Special Considerations for the Pediatric ECMO Patient
Apheresis Utilizing the ECMO Circuit
Special Considerations for Clinical Care
Blood Product Administration
Packed Red Blood Cells (PRBCs)
Fresh Frozen Plasma (FFP)
Platelets
Cryoprecipitate
Protocol for Platelet and Cryoprecipatate Administration
Amicar®
Editorial
Competencies
13. Management of the Cardiac ECMO Patient
Objectives
Introduction
Cardiac ECMO Indications
Cardiac Versus Pulmonary ECMO
Daily Management of the Cardiac ECMO Patient
 Complications
Weaning from ECMO
Appendix: Outcomes in Cardiac ECMO
14. Adult Extracorporeal Life Support
Objectives
Introduction
ECLS for Respiratory Failure
Cardiac Support
Conclusion
15. Medical and Surgical Management of the CDH Patient on ECMO
Objectives
Introduction
Indications for ECMO
Exclusion Criteria
Management on ECMO â€" What the ECMO Specialist Should Know
CDH Outcome
Summary
16. Extracorporeal Life Support during Cardiac Arrest (ECPR)
Objectives
Introduction
If you decide to do ECPR
Post Cannulation Care
Advantages and Disadvantages
Outcome
Summary
17. Hemofiltration and Hemodialysis on ECMO
Objectives
Background
Introduction
Hemofiltration versus hemodialysis
Equipment
Pros and Cons of Setup Options
Coagulation Management Differences
 Management Goals
Other Indications for Hemofiltration and Hemodiafiltration
18. Plasmapheresis for the ECMO Patient
Objectives
Introduction
Selected Indications for Plasmapheresis
Principles of Therapeutic Plasma Exchange (TPE) Operation
Specific Apheresis Considerations for the ECMO Circuit
Specific humoral considerations of Therapeutic Apheresis
Cardiorespiratory, Metabolic and Hematalogic Considerations
Cardiorespiratory Considerations
Metabolic Considerations
Hematologic Considerations
Circuit Priming
Anticoagulation Issues
Patient Care of ECMO TPE Patient
Complications
Apheresis Specialist Training and Competencies
Planned maintenance, calibration testing and Procedure for equipment failur
19. Cooling Neonates for Cerebral Protection on ECMO
Objectives
Introduction
Editorial
20. Responsibilities of the ECMO Specialists and RN Staff
Objectives
Introduction
Responsibilities of the ECMO Specialist and the Nursing Staff
21. ECMO Intra-Hospital Transport: Minimizing Risk
Objectives
Introduction
Background
Methodology
Preparation and Equipment
 Transport
Conclusions and Recomendations
22. Outcome After Neonatal ECMO
Objectives
23. Outcome Following Pediatric ECMO
Objectives
Introduction
24. Case Scenarios - Neonatal, Cardiac, ECPR, Adult, Pediatric
Objectives
Introduction
Neonatal Case Scenario
Cardiac Case Scenario
ECPR Patient Case Scenario
Adult Respiratory Failure Patient Case Scenario
Pediatric Respiratory Failure Case Scenario
25. Trouble Shooting: The What-If's of ECMO
Objectives
Introduction: