NICU Equipment and operations ECMO, IVs, and much more

 

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2,000th ECMO patient

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NICU equipment can serve many different purposes from monitoring your preemie’s health and vitals to supporting their breathing. One of the most frequently asked-about devices is the extracorporeal membrane oxygenation (ECMO) equipment, so before we look at other NICU equipment and procedures, let’s first look at ECMO. Some of the equipment often used in the NICU includes: Heart or cardiorespiratory monitor. This monitor displays a baby’s heart and breathing rates and patterns on a screen.

Wires from the monitor are attached to adhesive patches on the skin of the baby’s chest, and abdomen. What equipment is commonly used in the NICU? Providers use lots of equipment in the NICU to help take care of your baby.

Each piece has a special purpose in your baby’s treatment. If you have questions about any equipment used to treat your baby, ask his health care provider or the nurses in the NICU. NICUs are equipped with complex machines and devices to monitor nearly every system of a baby’s body temperature, heart rate, breathing, oxygen and carbon dioxide levels, and blood pressure.

A CT scan is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more. Some of the equipment often used in the NICU includes: Heart or cardiorespiratory monitor. This monitor displays a baby’s heart and breathing rates and patterns on a screen.

Wires from the monitor are attached to adhesive patches on the skin of the baby’s chest, and abdomen. A CT scan is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more.

It begins in the NICU and continues at home. Learn more about preemie care and their special health concerns. Premature babies require special attention. It begins in the NICU and continues at home.

NICU Equipment and Procedures: ECMO, IVs, and More. Medically reviewed by Joel Forman, MD Should You Co-Bed Twins and Multiples in the NICU?The Cardiac NICU at CHOC provides comprehensive care for babies with congenital heart defects, including those complicated by prematurity, low birth weight or multi-organ disease.CHOC is the only hospital in Orange County that performs open heart surgery on newborns.Led by physicians who are dual-trained in both neonatal intensive care and cardiac intensive care, the eight-bed Cardiac NICU. Procedure.

Being placed on ECMO requires a surgical procedure but it is usually done in a patient’s room. The patient is sedated and given pain medication and an anti-coagulant to minimize blood clotting. A surgeon, assisted by an operating room team, inserts the ECMO catheters into either an artery or veins.

List of related literature:

Part 1 will focus on the complications of extracorporeal membrane oxygenation (ECMO), including venoarterial (VA) and venovenous (VV) ECMO and ECMO cardiopulmonary resuscitation (ECPR).

“Mechanical Circulatory and Respiratory Support” by Shaun Gregory, Michael Stevens, John F Fraser
from Mechanical Circulatory and Respiratory Support
by Shaun Gregory, Michael Stevens, John F Fraser
Elsevier Science, 2017

A common model to move such patients is to combine the ECMO team with a standard retrieval team.

“Oh's Intensive Care Manual E-Book” by Andrew D Bersten, Jonathan Handy
from Oh’s Intensive Care Manual E-Book
by Andrew D Bersten, Jonathan Handy
Elsevier Health Sciences, 2018

ECMO is the most labor-intensive procedure in the neonatal intensive care unit (NICU).

“Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant” by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
from Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant
by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
Elsevier Health Sciences, 2010

Procedure Cart Aside from endotracheal intubations, the procedures that are commonly performed in the TRS include the insertion of large-bore peripheral venous catheters, chest tubes, central venous catheters, arterial lines, nasogastric tubes, and bladder catheters.

“Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I” by William C. Wilson, Christopher M. Grande, David B. Hoyt
from Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Volume I
by William C. Wilson, Christopher M. Grande, David B. Hoyt
CRC Press, 2007

Extracorporeal Membrane Oxygenation: Infants with MAS make up approximately 35% of those neonates who require ECMO.

“Textbook of Pulmonary and Critical Care Medicine Vols 1 and 2” by SK Jindal, PS Shankar, Suhail Raoof, Dheeraj Gupta
from Textbook of Pulmonary and Critical Care Medicine Vols 1 and 2
by SK Jindal, PS Shankar, Suhail Raoof, Dheeraj Gupta
Jaypee Brothers Medical Publishers, 2011

In addition to stabilization of the infant’s condition (oxygenation and perfusion of tissues), other preoperative interventions, such as nasogastric tube placement for abdominal decompression, pain management, and the maintenance of fluid and electrolyte balance, are implemented to manage specific problems.

“Maternal Child Nursing Care in Canada E-Book” by Shannon E. Perry, Marilyn J. Hockenberry, Deitra Leonard Lowdermilk, Lisa Keenan-Lindsay, David Wilson, Cheryl A. Sams
from Maternal Child Nursing Care in Canada E-Book
by Shannon E. Perry, Marilyn J. Hockenberry, et. al.
Elsevier Health Sciences, 2016

Typically venoarterial (VA) ECMO is utilized to unload the RV while maintaining systemic oxygenation.

“Principles of Adult Surgical Critical Care” by Niels D. Martin, Lewis J. Kaplan
from Principles of Adult Surgical Critical Care
by Niels D. Martin, Lewis J. Kaplan
Springer International Publishing, 2016

Ideally, centers without ECMO capability have prospective criteria to guide the transfer of newborns before the need for ECMO cannulation.

“Avery's Diseases of the Newborn E-Book” by Christine A. Gleason, Sherin Devaskar
from Avery’s Diseases of the Newborn E-Book
by Christine A. Gleason, Sherin Devaskar
Elsevier Health Sciences, 2011

Depending on the dose of radiation calculated, the catheters are after-loaded postoperatively, and if multiple treatments are required, the appliances are removed and reinserted at dose-calculated intervals.

“Pocket Guide to the Operating Room” by Maxine A Goldman
from Pocket Guide to the Operating Room
by Maxine A Goldman
F.A. Davis Company, 2019

A solid knowledge of hemodynamic and respiratory physiology is mandatory to take care of patients undergoing ECMO.

“ECMO-Extracorporeal Life Support in Adults” by Fabio Sangalli, Nicolò Patroniti, Antonio Pesenti
from ECMO-Extracorporeal Life Support in Adults
by Fabio Sangalli, Nicolò Patroniti, Antonio Pesenti
Springer Milan, 2014

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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4 comments

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  • My son was on ecmo when he was born. he swallowed his bowel movement when I was delivering him. My son was 10 lb when he was born and he was very very sick. He is now 27 with no problems this machine really works it saved my son’s life. I was so sacred and heart broken to see him hooked up to all those machines. But so grateful without them he wouldn’t have survived.

  • Great tips!!

    Retired Paramedic here….I always had success using a BP cuff. Apply BP cuff, identify the distal pulse, inflate just until you lose the pulse, then slowly deflate just until you feel the pulse. The idea is to stop the flow in the vein, while allowing the pulse pressure to build up, distending the vein. I been able to get a couple of choices on patients that others couldn’t find anything.

  • My brother is currently on ecmo at the University of Michigan. My family is so scared but we have all of our hope in the machine and these smart wonderful doctors and nurses. <3 thank god for ecmo.

  • ECMO saved my son Sean. He had a CCAM (Congenital Cystic Adenomatoid Malformation). He was put on ECMO on day 1 of life and remained on for 21 days. We are so appreciative for this life saving machine.