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Domande frequenti relative al Progetto ECMO: Cosa significa ECMO? ECMO è un acronimo composto da Extra Corporeal Membrane Oxigenation. A cosa serve?E'una ...

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      Content: Domande frequenti relative al Progetto ECMO: Cosa significa ECMO? ECMO è un acronimo composto da Extra Corporeal Membrane Oxigenation. A cosa serve?E'una tecnica di supporto cardiopolmonare che riduce la mortalità nei pazienti con insufficienza cardiaca e/o respiratoria acuta grave, potenzialmente reversibile ma refrattaria al trattamento medico farmacologico convenzionale Come funziona?l'ECMO è un sistema che permette, attraverso l'uso di una pompa, diprelevare il sangue del paziente da un distretto venoso (es. vena femorale), ossigenarlo attraverso un ossigenatore per poi infinereinserirlo in circolo in undistretto arterioso/venoso. L’ECMO è, quindi, un intervento non terapeutico, ma di supporto che mantiene il cuore e/o i polmoni a riposo permettendo cosi il loro recupero funzionale. Quali pazienti possono essere trattati con ECMO?L'ECMOè un trattamento invasivo con molte potenziali complicazioni, percio è richiesta un’accuratissima selezione dei pazienti da sottoporvi.Esistono dei criteri di inclusione ed esclusione riguardo la selezione dei pazienti da trattare con ECMO Quali sono i criteri di inclusione ed esclusione dei pazienti al trattamento con ECMO?I criteri di inclusione sono i seguenti:Eta’ compresa tra 18 e 75 anniPaz. con evento ischemico cardiaco acuto certificato da ECG eseguito a domicilio da equipaggio con medico del 118, che nel corso del trasporto vada incontro ad instabilità emodinamica grave (shock cardiogeno e PA sistolica < 90 nonostante infusione di amine ad alto dosaggio), e/o episodi ripetuti di alterazioni del ritmo cardiaco (BEV,TV,FV), e/o insorgenza di ACC senza ripresa del circolo e successiva stabilizzazione.Paz. ospedalizzati in shock cardiogeno che nonostante le terapie praticate ( infusione di amine a dosaggi elevati e/o contropulsatore) non riescano a mantenere una PA sistolica > di 70, e/o ripetuti episodi di alterazione del ritmo cardiaco (BEV,TV,FV), e/o insorgenza di ACC senza ripresa del circolo e successiva stabilizzazione. La genesi dello shock in questo caso può essere anche di natura non ischemica oppure complicanza di un episodio ischemico acuto ( tamponamento cardiaco da rottura di ventricolo, da dissecazione aortica, da dissecazione coronaria; embolia polmonare massiva, intossicazione da farmaci miocardiodepressori).Politrauma Criteri di esclusione dei pazienti:Pazienti che nonostante la coesistenza dei criteri di inclusione su indicati siano portatori di:Cardiomiopatia avanzata NYHA 3-4 senza prospettiva di trapianto cardiaco,Insufficienza aortica nota,Grave arteriopatia degli arti inferiori notaInsufficienza renale cronica in dialisi,Patologie neoplastiche terminali e neurologiche degenerative.

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