Quick tip for families in Intensive care: Can a tracheostomy be done while on ECMO?

https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-can-a-tracheostomy-be-done-while-on-ecmo/

Quick tip for families in Intensive care: Can a tracheostomy be done while on ECMO?

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i, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, one of the questions we get quite frequently, especially when families have a loved one on ECMO in ICU for either heart failure or for lung failure, they’re asking, “Can my loved one have a tracheostomy while they’re on ECMO?” And that’s a great question. And again, a question that needs to be answered for families in intensive care.

So, when patients are on ECMO (extracorporeal membrane oxygenation), they are also, most of the time, on a medication called heparin. Heparin is a blood thinner because blood is being taken out of the body, and run through a filter. And where the gas exchange is taking place, meaning oxygen is being induced into the bloodstream and then into the body and carbon dioxide is removed, as similar to the function of the lung. Heparin needs to be used to prevent the blood from clotting, prevent thrombosis, and to prevent emboli.

So therefore, a patient on ECMO is at a fairly high risk of bleeding. The aPTT (activated partial thromboplastin time), which is the clotting factor in the blood needs to be monitored very closely, multiple times a day, when someone is on ECMO and heparin. Therefore, the risk for a tracheostomy is pretty high or to do a tracheostomy is pretty high. And it means, a tracheostomy in ECMO is a very high risk because of the risk for a significant bleed when doing the tracheostomy, because the tracheostomy is a surgical procedure.

Continuation...
https://intensivecarehotline.com/blog/quick-tip-for-families-in-intensive-care-can-a-tracheostomy-be-done-while-on-ecmo/