Devices and monitoring during neonatal ECMO: survey results.
A survey of active ECMO centres regarding neonatal ECMO equipment and personnel was obtained by telephone interview in late summer 1989. Forty-seven of the centres in the USA listed in the Ann Arbor ELSO (Extracorporeal Life Support Organization) Registry at the time ( greater than 90%) were contacted and all participated.  Nearly all use a roller pump, while less than 5% use a centrifugal pump.  All programmes use a SciMed membrane oxygenator and 90% a SciMed heat exchanger.  Heat exchanger water sources include the Gaymar T-pump (42%), Seabrook (25%) and Cincinnati Sub-Zero (23%) units.  Eighty-seven per cent use a bladder box servo-regulated to the roller pump; these are most often custom-made (69%) but 13% of programmes use a commercially available (Seabrook) bladder box.  Ten per cent use a pressure-regulated roller pump rather than a conventional (displacement) bladder box to detect decreases in venous return.  Nearly 80% monitor circuit line pressures between the pump and patient.  Seventeen per cent use an air bubble detector on the arterial side of the circuit.  Only 10% use an arterial bubble trap and 6% an arterial line filter.  Seventy-five per cent do not monitor gas line pressures into the membrane lung, but one-third do use a gas line pop-off valve to prevent elevated gas phase pressures. Seventy per cent reported use of continuous in-line measurement of mixed venous oxygen saturation; no programme reported any blood chemistries being monitored in line.(ABSTRACT TRUNCATED AT 250 WORDS)
Allison
P L
PL
Extracorporeal Membrane Oxygenation Program, University of Texas Medical Branch, Galveston 77550.
Kurusz
M
M
Graves
D F
DF
Zwischenberger
J B
JB
D003625:Data Collection; D004869:Equipment Safety; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000592:standards / Q000706:statistics & numerical data; D006782:Hospitals, Special; D006801:Humans; D007231:Infant, Newborn; D008991:Monitoring, Physiologic; D010348:Patient Care Team; D015397:Program Evaluation; D012131:Respiratory Insufficiency / Q000628:therapy*