Extracorporeal Membrane Oxygenation (Ecmo) and Assistant Tools in Resuscitation

Extracorporeal membrane oxygenation (ECMO) provides blood flow and extracorpore al gas exchange by resting the heart and lungs in patients who develop respiratory and circulatory failure or are waiting for a heart-lung organ transplant. It is a temporary method that can provide short-term mechanical support to the heart and/or lungs in life-threatening situations. ECMO is a smaller, closed and portable version of the standard cardiopulmonary bypass device. There are 2 types of ECMO: Veno-venous (V-V) and Veno-arterial (V-A). Veno-venous (V-V) ECMO provides oxygenation in respiratory failure that does not respond to me chanical ventilation. It provides an important hemod ynamic contribution, such as allowing the right ventricle to work with less volume load and improving right ventricular functions and hypoxia. Veno-arterial (V-A) ECMO; Blood drains from the venous system and returns to the arterial system. It supports the treat ment of both respiratory and cardiac failure. The use and effectiveness of ECMO is gradually increasing in parallel with advancing technology and the increase in devices that can be easily placed on the patient and come into play quickly. ECMO is a multidisciplinary team work that requires experience, good training and knowledge. Interventional radiology, cardiovascular surgery, cardiology, intensive care team and an esthesiology clinics, as well as emergency medicine, have recently started to be on the agenda.
The main assistant devices used in resuscitation are: Defibrillator, Mechanical Chest Compression Device, Capnography, Airway Equipment, Ultrasonography, Echocardiography. The gold standard treatment for patients with ventricular fibrillation and pulseless ventricular tachycardia is rapid defibrillation. Mechanical cardiopulmonary resuscitation devices can be used to provide cardiac compression. Capnography provides information about ventilation, perfusion and metabolism in intubated or spontaneously breathing patients. Having key equipment at the bedside is a basic requirement for proper airway management. Ultrasonography can be used to visualize veins for central venous catheterization, identify elevated carotid artery pressure and measure central venous pressure noninvasively. Wall motion disorders are evaluated by echocardiography in patients with hemodynamic instability without a differential diagnosis, termination of resuscitation, or in patients in whom spontaneous circulation is restored.