肺移植可转换体外电路的设计与实现。

Q2 Health Professions Journal of Extra-Corporeal Technology Pub Date : 2022-09-01 DOI:10.1182/ject-242-249
Rachel Gambino, Desiree Bonadonna, William Dauch
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引用次数: 0

摘要

原位肺移植患者的术中管理可以在没有机械循环支持的情况下进行,使用静脉-动脉体外膜氧合(VA-ECMO)或体外循环(CPB)。对于某些患者,可能需要术中从VA-ECMO转换为CPB。如果VA-ECMO患者需要CPB转换,我们机构以前的模型使用两台独立的机器,总体效率低下。该项目的主要目的是开发一种CPB封装修改,以创建一个电路,可以很容易地从VA-ECMO转换为CPB。第二个目标是为我们的大灌注科创建新的支持方案和全面的教育和培训课程,以提高患者的安全。新电路经过精心设计和评估,以尽量减少对当前CPB电路的变化,同时允许VA-ECMO的最安全配置。通过多学科合作,设计了新的协议。制定了全面的教育和培训课程,以及客观的能力评估工具。灌注师对该电路进行了主观评估,并在易于设置,使用和CPB转换方面超过了我们之前的模型。它也得到了心胸外科医生和麻醉师的积极反馈。最后,它为我们的机构提供了经济利益。
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The Design and Implementation of a Convertible Extracorporeal Circuit for Lung Transplantation.

Intraoperative management for patients during orthotopic lung transplantation may be performed without mechanical circulatory support, with veno-arterial extracorporeal membrane oxygenation (VA-ECMO), or cardiopulmonary bypass (CPB). For certain patients, an intraoperative conversion from VA-ECMO to CPB may be indicated. If a VA-ECMO patient requires CPB conversion, the previous model at our institution used two separate machines and was overall inefficient. The primary aim of this project was to develop a CPB pack modification to create a circuit that easily converts from VA-ECMO to CPB if indicated. The secondary aim was to create new supportive protocols and a comprehensive education and training curriculum for our large perfusion department to enhance patient safety. The new circuit was carefully designed and evaluated to minimize changes to the current CPB circuit while allowing for the safest configuration of VA-ECMO. A new protocol was designed with multi-disciplinary collaboration. A comprehensive education and training curriculum, as well as an objective competency assessment tool, were created. The circuit was subjectively evaluated by perfusionists and outscored our previous model in the areas of ease of setup, use, and CPB conversion. It received positive feedback from cardiothoracic surgeons and anesthesiologists as well. Lastly, it provided a financial benefit to our institution.

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来源期刊
Journal of Extra-Corporeal Technology
Journal of Extra-Corporeal Technology Medicine-Medicine (all)
CiteScore
1.90
自引率
0.00%
发文量
12
期刊介绍: The Journal of Extracorporeal Technology is dedicated to the study and practice of Basic Science and Clinical issues related to extracorporeal circulation. Areas emphasized in the Journal include: •Cardiopulmonary Bypass •Cardiac Surgery •Cardiovascular Anesthesia •Hematology •Blood Management •Physiology •Fluid Dynamics •Laboratory Science •Coagulation and Hematology •Transfusion •Business Practices •Pediatric Perfusion •Total Quality Management • Evidence-Based Practices
期刊最新文献
First year update as cardiovascular perfusion's open access international journal. Extracorporeal cardiopulmonary resuscitation: lifesaving for the right patient, at the right time and in the right place. Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose. Examining Online International Health Professions Education: A Mixed Methods Review of Barriers, Facilitators, and Early Outcomes Building an Extracorporeal Cardiopulmonary Resuscitation Program at a High-Volume Extracorporeal Membrane Oxygenation Center
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