A single center's conversion from roller pump to centrifugal pump technology in extracorporeal membrane oxygenation.
Recent advances in blood pump technology have led to an increased use of centrifugal pumps for prolonged extracorporeal membrane oxygenation (ECMO). Data from the Extracorporeal Life Support Organization confirms that many institutions have converted to centrifugal pumps after prior experience with roller pump technology. Centrifugal pump technology is more compact and may generate less heat and hemolysis than a conventional roller pump. Based on the potential advantages of centrifugal pumps, a decision was made institution-wide to convert to centrifugal pump technology in pediatric implementation of ECMO. Based on limited prior experience with centrifugal pumps, a multidisciplinary approach was used to implement this new technology. The new centrifugal pump (Sorin Revolution, Arvada, CO) was intended for ECMO support in the cardiac intensive care unit (CICU), the pediatric intensive care unit (PICU) and the neonatal intensive care unit (NICU).
The perfusion team used their knowledge and expertise with centrifugal pumps to create the necessary teaching tools and interactive training sessions for the technical specialists who consisted primarily of registered nurses and respiratory therapists. The first phase consisted of educating all personnel involved in the care of the ECMO patient, followed by patient implementation in the CICU, followed by the PICU and NICU.
The institution-wide conversion took several months to complete and was well received among all disciplines in the CICU and PICU. The NICU personnel did use the centrifugal pump circuit, but decided to revert back to using the roller pump technology. A systematic transition from roller pump to centrifugal pump technology with a multidisciplinary team can ensure a safe and successful implementation.
1 Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Brandon C
BC
Shade
1 Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Kellie
K
Schiavo
1 Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Tami
T
Rosenthal
2 Department of Nursing, ECMO Program, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
James T
JT
Connelly
1 Department of Perfusion Services, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Richard W
RW
Melchior
centrifugal blood pumps; extracorporeal life support; extracorporeal membrane oxygenation; intensive care unit; roller pumps; technological advancement