Hemodynamic monitoring in the extracorporeal membrane oxygenation patient.

Journal Article (Review)

PURPOSE OF REVIEW: Hemodynamic monitoring in ECMO patients requires familiarity with the underlying pathophysiology and circulatory mechanics of extracorporeal flow. This review discusses the various monitoring modalities relevant to the management of patients on venovenous ECMO (VV ECMO) and venoarterial (VA ECMO). We emphasize tools to judge the adequacy of perfusion, predict the response to fluid boluses, measure right ventricular function, assess left ventricular distention (for VA ECMO), and monitor the process of weaning from ECMO. We emphasize how differences between VV ECMO and VA ECMO are reflected in distinct approaches to monitoring. RECENT FINDINGS: Point-of-care ultrasound and near-infrared spectroscopy can play a significant role in monitoring of global and regional perfusion. SUMMARY: Recent literature in hemodynamic monitoring of ECMO patients is discussed, with comparison of VV ECMO and VA ECMO. Many common monitoring tools lack validity during ECMO: by taking into account the unique physiology of the ECMO circulation, selected methods can aid in the care of these complex patients.

Full Text

Duke Authors

Cited Authors

  • Krishnan, S; Schmidt, GA

Published Date

  • June 2019

Published In

Volume / Issue

  • 25 / 3

Start / End Page

  • 285 - 291

PubMed ID

  • 30865613

Pubmed Central ID

  • 30865613

Electronic International Standard Serial Number (EISSN)

  • 1531-7072

Digital Object Identifier (DOI)

  • 10.1097/MCC.0000000000000602

Language

  • eng

Conference Location

  • United States