Not quite in guidelines yet but we simultaneously start cannulating for Ecmo immediately. Results are pretty impressive. On average can be on Ecmo faster than a surgeon can be there to open chest, and then we can figure out what’s going on.
Very interesting. Do you have a general guideline regarding the venous and arterial catheters for cardiac surgery patients? Like femoral arterial line for everybody and avoiding the right IJ for routine catheters so you can cannulate it for emergencies?
The expert guidance seems to generally assume epicardial pacing wires are still present postop, and implies or directly advises using these. I would consult with local experts as to extending the guidance to external pads. Pretty sure that the body of clinical experience doesn’t directly support that but this is not my sub-specialty area.
Not quite in guidelines yet but we simultaneously start cannulating for Ecmo immediately. Results are pretty impressive. On average can be on Ecmo faster than a surgeon can be there to open chest, and then we can figure out what’s going on.
Very interesting. Do you have a general guideline regarding the venous and arterial catheters for cardiac surgery patients? Like femoral arterial line for everybody and avoiding the right IJ for routine catheters so you can cannulate it for emergencies?
We do fem-fem for VA Ecmo.
When you talk about pacing (if available), do you mean only if internal pacing available? Or also pacing with external pads?
The expert guidance seems to generally assume epicardial pacing wires are still present postop, and implies or directly advises using these. I would consult with local experts as to extending the guidance to external pads. Pretty sure that the body of clinical experience doesn’t directly support that but this is not my sub-specialty area.