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ECMO Glossary

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ACT (Activated Clotting Time): a test to measure how long it takes for blood to form a clot.

Antibiotic: a medication given to treat bacterial infections.

Arterial Cannula: a large tube the surgeon placed into a blood vessel in the neck or chest.

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Blood Gas: is a sample of blood taken from an artery or vein that tells how well your child is receiving oxygen. The sample is taken from an artery (ABG), from a vein (VBG), or from a capillary (CBG).

Bridge to Transplant: when ECMO is used to help pump the patient's blood to vital organs until a suitable heart transplant can be obtained.

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CAT Scan (CT): a diagnostic test using x-rays to make a three dimensional image of the inside of the body such as organs. This test is performed to give the doctors more detail to provide better medical information.

Cannulas: tubes placed into blood vessels in the neck or chest by a surgeon that provide flow for the ECMO circuit.

Chest Tube: a tube that is placed in a space next to the lungs to help drain air or fluid.

Chest X-ray: a diagnostic test using x-rays to give the doctors a radiographic picture of the patient's lungs, heart, and other chest structures. These are performed daily in ECMO to assess cannula placement, chest tube placement, and lung condition.

Congenital Diaphragmatic Hernia (CDH): a life threatening medical condition that is present at birth characterized by a hole in the diaphragm or tissue that separates the lungs from the abdominal organs. The hole allows for abdominal organs to occupy the space that the lungs would normally grow in. Therefore, the lung(s) never develop to their normal size and do not function normally at birth.

Congenital Heart Defect (CHD): a medical condition, possibly life-threatening, which is present at birth and is characterized by an abnormal heart and/or heart vessels. The condition usually upsets the normal flow of blood in or out of the heart. These changes can cause the heart to work hard and less efficiently.

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Decannulate: to remove the tubes from the blood vessels. This is performed by the surgeon when a patient is taken off ECMO. However, this can occur as an emergent complication while on ECMO during transport, a procedure, or anything requiring the movement of the patient while on ECMO. Accidental decannulation is an extremely rare occurrence at ACH as our patient transports both mobile and within the hospital for tests and procedures is exceptional.

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a medical imaging tool using ultrasound to assess the function of the heart.

ECMO: is a technique of providing both heart and lung support outside the body with a heart/lung bypass machine. It provides oxygen to patients whose heart and lungs are so severely diseased that they can no longer serve their function.

ECMO Flow: The amount of blood flowing through the ECMO circuit per minute.

ECMO Pump: The machine that controls how much support the patient's heart/lungs is receiving. It can act as an artificial heart for the patient and pumps the blood through the oxygenator membrane back to the patient.

ECMO Team: the team that is composed of specially-trained Physicians, Registered Nurses, and Registered Respiratory Therapists.

Electroencephalogram (EEG): a diagnostic test given to record brain activity using small electrode placed on the patient's scalp. This test provides information on the brain activity normal or abnormal and can provide information concerning seizure activity.

Edema: is the swelling that can occur in any tissue or organ due to the excessive buildup or increase in fluid.

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Head Ultrasound: is a medical imaging tool using ultrasound to assess the head for bleeding and edema.

Heat Exchanger: a device used to warm the blood in the ECMO circuit before it returns to the patient.

Hemofiltration: is where blood is passed through a set of tubing (a filtration circuit) via the ECMO circuit to a membrane (the filter) where waste products and water are removed.

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Intraventricular Hemorrhage (IVH): is bleeding in the brain common in infants, especially premature infants or those of very low birth weight, thought to result from changes in circulation to structures that are present in the growing brain. The lack of blood flow causes the death of brain cells and the breakdown of the blood vessels of those cells which leads to bleeding. This bleeding is itself a marker for injury that has already occurred however continuous bleeding can result in further injury to the brain. ECMO can increase the risks for bleeding because the patient receives Heparin an anti-clotting medication and an IVH maybe a reason for discontinuing ECMO support.

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Life Threatening Asthma: is a disease of the lungs in which the airway sometimes constricts, becomes inflamed, and may have large amounts of fluid or mucus, often in as a result to one or more triggers. In life threatening asthma traditional means of treatment may not successfully manage the illness and ECMO can assist to "rest" the lungs.

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Meconium Aspiration (MAS): occurs when infants take meconium or stool into their lungs during or before delivery. This stool is sterile or germ-free but can cause serious problems for a newborn's lungs. ECMO can be utilized to "rest" the lungs until they regain their ability to provide oxygen to the infant.

Magnetic Resonance Imaging (MRI): a diagnostic tool used to see the inside structures of the body. This type of imaging is usually completed after a patient has been on ECMO as a follow-up procedure.

Membrane or Oxygenator: an artificial lung that adds oxygen to the patient's blood on ECMO and removes carbon dioxide.

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Persistent Pulmonary Hypertension of the Newborn (PPHN): a disease process in newborns where the blood pressure in the newborns lungs remains high and does not permit the regular flow of blood into the lungs to be oxygenated but rather mixes with blood flow to the body. The mixing occurs in the heart and/or through a blood vessel that should have closed shortly after birth called the ductus. The blood then supplied to the body is lacking oxygen.

Pneumonia: is a disease of the lungs in which the small air-filled sacs of the lung responsible for taking up oxygen are irritated and flooded with edema.

Platelets: are some of the basic mechanisms in the blood used for the formation of clots. Platelets are regularly monitored and replace in ECMO as the circuit consumes some of them from the circulating blood.

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Respiratory Distress/Failure: is a medical term for the inability of the lungs to exchange oxygen and/or carbon dioxide. Respiratory failure can be shown by observing a drop in oxygen in the blood (hypoxia) and/or a rise in carbon dioxide (hypercapnia). The patient's physician can observe these things from a blood gas level.

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Septic Shock: is a life threatening medical condition caused by infection and sepsis (overwhelming bloodstream infection). Children are among the common victims as their immune systems cannot cope with the infection. The results of sepsis can be failure of the primary organs to work such as heart, lungs, kidneys, liver, and even death.

Sudden Cardiac Arrest: is the rapid stop of normal blood flow due to failure of the heart to beat well. Sudden arrest prevents delivery of oxygen to the whole body. Brain injury will probably occur if the sudden cardiac arrest is untreated for more than five minutes.

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a machine that is attached to a tube in the patient's mouth or nose that delivers oxygen and removes carbon dioxide for patients who cannot breathe on their own.

Venous-arterial (VA) ECMO: is a type of ECMO that provides support for the heart and lungs. One cannula is placed in a large vein and one cannula is placed in a large artery.

Veno-venous (VV) ECMO: is a type of ECMO that provides support for the lungs only. One cannula is placed in a large vein.

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Weaning: is a process of slowly getting the child off ECMO, off a ventilator, or off medications as the patient's condition improves.

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Angel One Dispatch / 1-800-ACH-HELP

Ask to speak to the pediatric intensivist, cardiac intensivist or neonatologist on call, depending on the age of the child and primary problem.

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