North American neonatal extracorporeal membrane oxygenation (ECMO) devices and team roles: 2008 survey results of Extracorporeal Life Support Organization (ELSO) centers.
North American neonatal extracorporeal membrane oxygenation (ECMO) devices and team roles: 2008 survey results of Extracorporeal Life Support Organization (ELSO) centers.
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DOI：
10.1051/ject/200840166
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发表时间：
2008-09
期刊：
影响因子：
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通讯作者：
M. C. D. Scott Lawson;BS Andrea F. Lawson;BS Ccp Rich Walczak;Mps Ccp Craig McRobb;BS Ccp Patty McDermott;B. C. Ian R. Shearer;MD Andrew Lodge;MD James Jaggers
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文献类型：
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作者：
M. C. D. Scott Lawson;BS Andrea F. Lawson;BS Ccp Rich Walczak;Mps Ccp Craig McRobb;BS Ccp Patty McDermott;B. C. Ian R. Shearer;MD Andrew Lodge;MD James Jaggers
2008年初，通过电子邮件对北美主动体外膜肺氧合（ECMO）中心的新生儿ECMO设备和专业人员进行了调查。在体外生命支持组织目录中列为新生儿中心的 103 个北美 ECMO 中心中，有 80 个 (78%) 对调查做出了回应。在响应中心中，82.5% 的新生儿 ECMO 常规使用滚压泵，其余 17.5% 使用离心泵。 67%的受访者使用硅胶膜氧合器，19%使用微孔中空纤维氧合器，14%使用聚甲基戊烯中空纤维氧合器。在硅胶膜氧合器用户中，86%使用Medtronic Ecmotherm热交换器，10%使用Gish HE-4热交换器，4%使用Terumo Conducter设备。 64% 的响应中心使用某种形式的在线血气监测。 6% 的中心在动脉管路中使用气泡收集器，5% 的中心使用动脉管路过滤器。 85%的中心使用膀胱，其中4%使用机械膀胱箱进行伺服调节；其余96%采用压力伺服调节。 88% 的响应中心使用了气泡检测器。 44% 的中心对所有新生儿 ECMO 患者使用了表面涂层。 31% 的中心使用 180-220 秒的激活凝血时间。在 54% 的响应中心中，灌注师参与了 ECMO 计划，注册护士在 70% 的中心参与，呼吸治疗师在 46% 的中心参与。与2002年的调查相比，硅胶膜的使用正在下降，离心血泵和涂层ECMO回路的使用变得更加明显。 ECMO 团队仍然是多学科的，由注册护士、呼吸治疗师和灌注师组成。
In early 2008, surveys of active extracorporeal membrane oxygenation (ECMO) centers in North America were conducted by electronic mail regarding neonatal ECMO equipment and professional staff. Eighty of 103 (78%) North American ECMO centers listed in the Extracorporeal Life Support Organization directory as neonatal centers responded to the survey. Of the responding centers, 82.5% routinely used roller pumps for neonatal ECMO, and the remaining 17.5% used centrifugal pumps. Silicone membrane oxygenators were used by 67% of the respondents, whereas 19% used micro-porous hollow fiber oxygenators, and 14% used polymethylpentene hollow fiber oxygenators. Of the silicone membrane oxygenator users, 86% used the Medtronic Ecmotherm heat exchanger, 10% used the Gish HE-4 heat exchanger, and 4% used the Terumo Conducer device. Sixty-four percent of the responding centers used some form of in-line blood gas monitoring. Six percent of the centers used a bubble trap in the arterial line, and 5% used an arterial line filter. A bladder was used by 85% of the centers, and 4% of these used a mechanical bladder box for servo regulation; the remaining 96% used pressure servo regulation. An air bubble detector was used by 88% of the responding centers. A surface coating was used by 44% of the centers on all their neonatal ECMO patients. Thirty-one percent of the centers use an activated clotting time of 180-220 seconds. At 54% of the responding centers, perfusionists were involved with the ECMO program, registered nurses were involved at 70% of the centers, and respiratory therapists were involved at 46% of the centers. Compared with a 2002 survey, silicone membrane use is declining, and the use of centrifugal blood pumps and coated ECMO circuits is becoming more apparent. ECMO teams are still multidisciplinary, made up of combinations of registered nurses, respiratory therapists, and perfusionists.