North American neonatal extracorporeal membrane oxygenation (ECMO) devices: 2002 survey results.
In mid 2002, surveys of active extracorporeal membrane oxygenation (ECMO) centers in the United States and Canada were conducted via E-mail regarding neonatal equipment and personnel. Seventy-four out of 99 (75%) North American ECMO centers listed in the Extracorporeal Life Support Organization (ELSO) directory responded to the survey. Of the responding centers, 95% use roller pumps, and the remaining 5% use centrifugal pumps. Silicone membrane oxygenators were used by 97% of the respondents, while 3% used hollow fiber oxygenators. Of the silicone membrane oxygenator users, 82% used the Medtronic ECMOtherm heat exchanger, 15% used a Gish heat exchanger, and 3% used the Dideco D720 heat exchanger. Sixty-one percent of the responding centers used some form of in-line blood gas monitoring. Five percent of the centers used a bubble trap in the arterial line, and 12% used an arterial line filter. A bladder was used by 92% of the centers, and 29% used a mechanical bladder box for servo regulation, the remaining 71% used pressure servo regulation. An air bubble detector was used by 65% of the responding centers, although 81% had the device available. Heparin coating was used by 5% of the centers on all their neonatal ECMO patients. The average low range ACT was 183 seconds, and the average high range ACT was 216 seconds. At 49% of the responding centers, perfusionists were involved with the ECMO program, registered nurses were involved at 84% of the centers, and respiratory therapists were involved at 61% of the centers, perfusion assistants were involved at one center (1%), and biomedical engineers were involved at one of the centers. When compared to a 1990 survey, a shift away from using bladder boxes and toward using air bubble detectors is apparent. But other than those two shifts, ECMO is done in much the same manner as it was done 12 years ago.
Lawson
D Scott
DS
Duke University Health System, Durham, North Carolina 27710, USA. lawso008@mc.duke.edu
Walczak
Rich
R
Lawson
Andrea F
AF
Shearer
Ian R
IR
Ing
Richard
R
Schulman
Scott
S
Kern
Frank
F
Jaggers
James
J
D000925:Anticoagulants / Q000627:therapeutic use; D002170:Canada; D004865:Equipment and Supplies, Hospital / Q000145:classification / Q000706:statistics & numerical data; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014481:United States; D000078329:Workforce
D000925:Anticoagulants