patbas.blogg.se - Cardiohelp maquet manual

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Perhaps this patient cannot tolerate such a vigorous suction. The pump RPM might need to be turned down.One should think about abdominal compartment syndrome or some other reason as to why the big central vein where the cannula is might be underfilled.Some fluid resuscitation may be helpful (as it refills the central venous spaces, hopefully giving the venous access pump more pumpable substrate).The oxygenator and pump head should be inspected for clots, as these may be contributing to haemolysis.

Patient repositioning may be helpful (or more harmful, if you kink the cannula).First things first: check the cannula.Excessive pump suction for a given cannula diameter.One is alerted to this not by routine bloods, but by the presence of bright red haemoglobinuria.Generally an access pressure in excess of 250 mmHg will give rise to haemolysis. However, if the venous access is in trouble, the high suction at the cannula tip will shred more red cells.Usually, the rate of haemolysis is kept under control.This happens because of the perverse environment of the circuit, and its unfriendlyness to the red cells within it.

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Haemolysis: anaemia and the rise of free haemoglobin

The reason this happens is the vein collapses intermittently around the access cannula tip, causing the intracannula pressure to briefly become very negative (which causes the atmospheric pressure to forcefully straighten the tube).

This is when the venous access line keeps wiggling randomly, like a fire hose.

The problem is usually with the venous access line or poor venous pressure.

The L/min number keeps fluctuating wildly.

This is when the venous access pump is unable to maintain a constant flow rate.

Access issues Flow fluctuations in the access pump