title: Novel Utilization of the Bridge During Weaning Off Venoarterial ECMO: The Hoffman Clamp Method.
abstract: Standard practice for weaning patients off venoarterial extracorporeal membrane oxygenation (ECMO) occurs by decreasing pump flows until idle flow is achieved. This method is limited in its use because it is difficult to assess a patient's true potential to successfully come off ECMO when supported by idle flow. We have developed a weaning technique that uses a Hoffman clamp on the bridge to decrease blood flow to the patient beyond idle flow. This method was used to wean eight patients from venoarterial ECMO. No patients weaned with this technique required emergent reinstitution of ECMO. The Hoffman clamp technique has allowed us to safely wean patients off ECMO support while maintaining integrity of the circuit.
authors.affiliation: From the *Department of Cardiothoracic Surgery, Divisions of †Respiratory Care and ‡Nursing, University of Iowa Children's Hospital, Iowa City, IA USA; and §Department of Pediatric Cardiology, Children's Hospital Colorado, Aurora, CO USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Holgren
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Frede
authors.forename: Jennifer P
authors.initials: JP
authors.lastname: Crumley
authors.forename: Sonali S
authors.initials: SS
authors.lastname: Patel
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Moore
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Turek
mesh_terms: D002648:Child; D002675:Child, Preschool; D003250:Constriction; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000503:physiopathology*; D008297:Male; D020127:Recovery of Function