Quality Assurance in Extracorporeal Membrane Oxygenation Patients

Abstract

The selection of patients for extracorporeal membrane oxygenation (ECMO) support is a critical component of any perfusion program. Teams must evaluate when to start the support, how long to support the patient, and when is the ideal time to wean. The timing of ECMO support is debated. While some programs emphasize prompt timing, others suggest the conservative approach is better (>7 hours). Delaying ECMO support could increase complications; thus, more evidence has been attained for prompt support. Importantly, complications are common with ECMO support. Despite advances in ECMO support over the last ten years, bleeding remains a high risk. Current guidelines have evolved based on the findings. One of the newest technologies is Cytosorb (CytoSorbents Inc.); however, the optimization of its use and its true efficacy is unknown. Our institution has recently used the Seraph 1000 Microbind Affinity blood filter, which allows up to a 90% reduction of bloodstream pathogens during a single treatment, and we have found it to be a highly effective approach and a possible advancement in treating septic patients.