ECMO---cannulation techniques?

[stevierae]

I hope I have posted this in the right section----I didn't see one for Cath Lab. I know ECMO is occasionally done in ICU settings (for adults) and, of course, in PICU or NICU for pediatric patients.

Or, interventional cardiology (isn't that the same as Cath Lab?) or perhaps interventional radiology....

I am trying to visualize the technique used for cannulation of the IJ over a guide wire, or cutdown. Is it generally done under fluoroscopy, as pacemakers, cardiac caths, angioplasties, intraaortic balloon pumps (I think) and other invasive cardiology procedures are done?

Can it be threaded all the way down utilizing ultrasound, or doppler? Is a post-op chest-film to determine accurate placement OK in case fluoro or ultrasound is not available? I have googled endlessly and can't come up with a specific standard of care regarding ECMO placement. I am an operating room nurse, but don't do hearts at the facility where I currently work. Where I used to work, they utilized VADS, but I am unfamiliar with ECMO. We didn't do neonates or peds, so maybe that's why we heard about VADS, not ECMO. I rarely worked in the heart room, except for breaks, so I've never seen VADS implemented, either--just heard about it.

[candyndel]

You should move this to the peds forum....

I hope I have posted this in the right section----I didn't see one for Cath Lab. I know ECMO is occasionally done in ICU settings (for adults) and, of course, in PICU or NICU for pediatric patients.

Or, interventional cardiology (isn't that the same as Cath Lab?) or perhaps interventional radiology....

I am trying to visualize the technique used for cannulation of the IJ over a guide wire, or cutdown. Is it generally done under fluoroscopy, as pacemakers, cardiac caths, angioplasties, intraaortic balloon pumps (I think) and other invasive cardiology procedures are done?

Can it be threaded all the way down utilizing ultrasound, or doppler? Is a post-op chest-film to determine accurate placement OK in case fluoro or ultrasound is not available? I have googled endlessly and can't come up with a specific standard of care regarding ECMO placement. I am an operating room nurse, but don't do hearts at the facility where I currently work. Where I used to work, they utilized VADS, but I am unfamiliar with ECMO. We didn't do neonates or peds, so maybe that's why we heard about VADS, not ECMO. I rarely worked in the heart room, except for breaks, so I've never seen VADS implemented, either--just heard about it.