Application of Extracorporeal Membran Oxygenation in Children and Nursing Care

Year 2019, , 398 - 405, 01.06.2019

Gizem Kerimoğlu Yıldız , Birsen Mutlu

https://doi.org/10.17681/hsp.435687

Abstract

DOI:10.17681/hsp.435687

Extracorporeal Membrane Oxygenation (ECMO) is a life-saving application which is used
as a temporary and artificial support in providing acute circulatory support or
respiratory failure of infants/children who have had recent cardiopulmonary
insufficiency or cardiac arrest. ECMO is applied as Veno-venous ECMO and
Veno-arterial ECMO according to the veins of the cannulation. Patients usually
need to be supported by ECMO for days and weeks to be able to recover. However,
since ECMO is a highly invasive and complex procedure, it can also cause
serious complications in newborns and children. Therefore, ECMO needs to be
performed by a specially trained health professionals team. Nurses as members
of the team should be active both in providing care for children in intensive
care setting and in preparing the family for the process and the procedure.
ECMO nurse needs to follow all the vital parameters, arterial blood gases, ECMO
parameters, fluid intake and output and neurologic conditions of the patient
and needs to be careful about the risk of any complications and inform the
physician when necessary. The nurse should do daily care of the child and
provide proper nutrition to the child. Despite the fact that in the world and
in Turkey ECMO is an increasing application in intensive care, as a result of
the literature reviews, it is noticed that the studies and publications about
this subject are low in our country. Therefore, it is aimed to compile and
share information about this subject.

Keywords

Extracorporeal membrane oxygenation, Child, Nursing care

Çocuklarda Ekstrakorporal Membran Oksijenasyonu Uygulaması ve Hemşirelik Bakımı

Abstract

DOI:10.17681/hsp.435687

Ekstrakorporal Membran Oksijenasyonu (EKMO) son dönem kardiyopulmuner
yetersizlik veya kardiyak arrest geçiren bebeklerde/çocuklarda akut dolaşım
desteğini sağlayabilmek amacıyla ya da solunum yetmezliğinde, geçici ve yapay bir destek olarak
kullanılan kurtarıcı bir uygulamadır. EKMO
kanülasyonun yapıldığı
damarlara göre Venö-venöz EKMO ve Venö-arteriyel EKMO olarak uygulanmaktadır. Hastaların
iyileşebilmesi için genellikle günlerce ve haftalarca EKMO ile desteklenmeleri
gerekmektedir. Ancak EKMO uygulaması oldukça invazif ve kompleks bir uygulama
olması nedeniyle yenidoğanlarda ve çocuklarda ciddi komplikasyonlara da neden
olabilmektedir. Bu nedenle EKMO özel olarak eğitim almış sağlık çalışanları ve
bir ekip tarafından uygulanmalıdır. Ekibin bir üyesi olan hemşirenin hem
çocuğun yoğun bakım ortamındaki bakımının sağlanmasında hem de ailenin işleme
ve sürece hazırlanmasında oldukça aktif olması gerekmektedir. EKMO hemşiresi
hastanın tüm yaşamsal parametrelerini, kan gazlarını, EKMO parametrelerini,
aldığı-çıkardığını ve nörolojik durumunu takip etmeli, herhangi bir
komplikasyon gelişmesi riskine yönelik dikkatli olmalı, gereken durumlarda
hekimi bilgilendirmelidir. Çocuğun günlük bakımını yapmalı ve uygun yöntemle
beslenmesini sağlamalıdır. Dünya’da ve Türkiye’de EKMO uygulamasının yoğun
bakımlarda giderek artan bir uygulama olmasına rağmen literatür incelemeleri
sonucunda ülkemizde bu konuya ilişkin yapılan çalışmaların ve yayınların azlığı
dikkat çekmiştir. Bu nedenle bu konuya ilişkin bilgilerin derlenerek
paylaşılması amaçlanmıştır.

Keywords

Çocuk, hemşirelik bakımı, ekstrakorporeal membran oksijenasyonu

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