{"id":16407,"date":"2022-08-31T14:25:40","date_gmt":"2022-08-31T17:25:40","guid":{"rendered":"https:\/\/mindthegraph.com\/blog\/stem-cell-research-pros-and-cons-copy\/"},"modified":"2022-11-24T12:30:09","modified_gmt":"2022-11-24T15:30:09","slug":"va-ecmo","status":"publish","type":"post","link":"https:\/\/mindthegraph.com\/blog\/nb\/va-ecmo\/","title":{"rendered":"VA ECMO: Hva det er og hvordan det kan brukes til \u00e5 redde liv"},"content":{"rendered":"<p>Ekstrakorporeal membranoksygenering, ogs\u00e5 kjent som ECMO, brukes ved intensivbehandling n\u00e5r hjertet og lungene trenger hjelp for at kroppen skal komme seg.&nbsp;<\/p>\n\n\n\n<p>An ECMO machine is similar to the heart-lung by-pass machine used in open-heart surgery and involves pumping blood from outside the body to a heart-lung, which eliminates carbon dioxide and returns oxygenated blood to the body&#8217;s tissues. Blood passes from the right side of the heart to the heart-lung machine&#8217;s membrane oxygenator, where it is rewarmed and returned to the body. This machine allows the heart and lungs to rest and recover.<\/p>\n\n\n\n<p>Det finnes to typer ECMO: VV ECMO og <strong>VA ECMO<\/strong>. I denne artikkelen vil du l\u00e6re mer om <strong>VA ECMO<\/strong> og hvordan man skiller mellom de to typene.<\/p>\n\n\n\n<h2>Hva er en VA ECMO og hvordan fungerer den?<\/h2>\n\n\n\n<p>En veno-arteriell ECMO, eller<strong> VA ECMO<\/strong>, is a machine used to enable the majority of the patient&#8217;s blood to travel through the circuit without passing through the heart. This kind of ECMO transfers blood from a large vein to remove unoxygenated blood from the body to a large artery, enabling oxygenated blood to flow throughout the body even when the heart is too frail to pump it.&nbsp;<\/p>\n\n\n\n<p>Den kan legges inn via en perifer eller sentral tilgang og brukes vanligvis p\u00e5 operasjonsstuen for \u00e5 gi kortvarig assistanse, s\u00e6rlig til pasienter som har gjennomg\u00e5tt en kardiotomi og ikke har klart \u00e5 komme seg ut av den kardiopulmonale bypassen. Hjertet vil fortsette \u00e5 sl\u00e5 mens det er tilkoblet VA ECMO, men jobben blir mye enklere fordi ECMO-maskinen utf\u00f8rer mesteparten av pumpingen.<\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><a href=\"https:\/\/mindthegraph.com\/blog\/wp-content\/uploads\/2022\/08\/preview_466244-1.png\"><img decoding=\"async\" src=\"https:\/\/mindthegraph.com\/blog\/wp-content\/uploads\/2022\/08\/preview_466244-1.png\" alt=\"\" class=\"wp-image-16582\"\/><\/a><figcaption class=\"wp-element-caption\"><em>Laget med<a href=\"https:\/\/mindthegraph.com\"> Mind the Graph<\/a><\/em><\/figcaption><\/figure><\/div>\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2>Typer ECMO<\/h2>\n\n\n\n<p>I tillegg til <strong>VA ECMO<\/strong>finnes det VV ECMO, og begge er ganske like. Veno-ven\u00f8s ECMO fjerner og returnerer blod til det ven\u00f8se kretsl\u00f8pet samtidig. Tilgangen skjer vanligvis via en enkelt Y-formet kanyle som f\u00f8res inn i den indre halsvenen, slik at blodet forlater og returnerer til kroppen p\u00e5 ett og samme sted, og man trenger bare ett inngangssted i stedet for to. I visse tilfeller kan imidlertid flere enkeltlumenkanyler f\u00f8res inn i halsen og\/eller lyskene.&nbsp;<\/p>\n\n\n\n<p>Only the lungs are supported by VV ECMO, the patient&#8217;s heart must still operate adequately to satisfy the demands of the body.&nbsp;<\/p>\n\n\n\n<h2>De viktigste forskjellene mellom VA ECMO og VV ECMO<\/h2>\n\n\n\n<ul class=\"has-black-color has-cyan-bluish-gray-background-color has-text-color has-background\">\n<li>VV ECMO st\u00f8tter utelukkende lungene, mens VA ECMO st\u00f8tter b\u00e5de lungene og hjertet.<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-black-color has-cyan-bluish-gray-background-color has-text-color has-background\">\n<li>Begge ECMO-apparatene drenerer blod fra h\u00f8yre atrium, men VA returnerer det via vena cava inferior eller superior, mens VV returnerer det via arteria femoralis, arteria subclavia eller arteria carotis.<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-black-color has-cyan-bluish-gray-background-color has-text-color has-background\">\n<li>VA ECMO-pasienter er mer utsatt for luftembolier og bl\u00f8dninger, mens VV-pasienter er mindre utsatt for disse problemene.<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-black-color has-cyan-bluish-gray-background-color has-text-color has-background\">\n<li>VA ECMO can be used for right ventricular failure, while VV can&#8217;t be used<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-black-color has-cyan-bluish-gray-background-color has-text-color has-background\">\n<li>VV ECMO har h\u00f8yere perforasjonsfrekvens og VA lavere.<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-black-color has-cyan-bluish-gray-background-color has-text-color has-background\">\n<li>Ved bruk av VA ECMO oppn\u00e5s h\u00f8yere PaO2 sammenlignet med VV ECMO.<\/li>\n<\/ul>\n\n\n\n<div style=\"height:15px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"is-content-justification-center is-layout-flex wp-container-1 wp-block-buttons\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-background wp-element-button\" href=\"https:\/\/mindthegraph.com\/app\/illustrations?search=va%20ecmo\" style=\"border-radius:50px;background-color:#dc1866\" target=\"_blank\" rel=\"noreferrer noopener\">Klikk her for \u00e5 se ECMO-illustrasjoner<\/a><\/div>\n<\/div>\n\n\n\n<div style=\"height:15px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2>Hvem trenger ECMO?<\/h2>\n\n\n\n<p>Generelt sett er ECMO en type livsopprettholdende behandling som er tilgjengelig for alle, inkludert spedbarn, barn og voksne, som har livstruende hjerte- og\/eller lungesykdommer, f.eks:<\/p>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Lungeemboli<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Hjertestans<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Hyperkapnisk respirasjonssvikt med en arteriell pH p\u00e5 mindre enn 7,20<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Postkardiotomipasienter som ikke har v\u00e6rt i stand til \u00e5 komme seg ut av den kardiopulmonale bypassen<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Som et skritt i retning av hjerte- eller lungetransplantasjon eller implantasjon av en ventrikkelassistanseenhet<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Hjertemuskelsykdom (dekompensert kardiomyopati)<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Betennelse i hjertemuskelen (myokarditt)<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Akutt lungesviktsyndrom<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Traumer<\/li>\n<\/ul>\n\n\n\n<ul class=\"has-white-color has-text-color has-background\" style=\"background-color:#dc1866\">\n<li>Livstruende infeksjonsreaksjon (sepsis)<\/li>\n<\/ul>\n\n\n\n<h2>Risiko og komplikasjoner<\/h2>\n\n\n\n<h3>Bl\u00f8dning<\/h3>\n\n\n\n<p>Den vanligste konsekvensen av ECMO er bl\u00f8dning. Dette skyldes at heparin tilf\u00f8res ECMO-kretsen for \u00e5 forhindre at det dannes blodpropper. Heparin gj\u00f8r dette ved \u00e5 tynne ut blodet, noe som gj\u00f8r det mindre sannsynlig at det dannes blodpropper. Vanligvis oppst\u00e5r bl\u00f8dninger ved ECMO-kanyler eller andre kirurgiske steder p\u00e5 kroppen. Mens pasienten tar heparin, kan det imidlertid oppst\u00e5 bl\u00f8dninger hvor som helst i kroppen. De alvorligste bl\u00f8dningene kan oppst\u00e5 i eller i n\u00e6rheten av hjernen. Derfor holder ECMO-teamet kontinuerlig \u00f8ye med og analyserer symptomer p\u00e5 bl\u00f8dning.<\/p>\n\n\n\n<h3>Kretsfeil eller brudd<\/h3>\n\n\n\n<p>Det er vanlig \u00e5 observere et brudd i kretsen, og i slike situasjoner er fagpersonene oppl\u00e6rt til \u00e5 reagere umiddelbart for \u00e5 l\u00f8se problemet. F\u00f8r ECMO-maskinen repareres eller skiftes ut, m\u00e5 pasienten tas ut av maskinen. I denne perioden vil pasienten bli tatt h\u00e5nd om inntil ECMO-behandlingen kan gjenopptas.<\/p>\n\n\n\n<h3>Blodpropper eller luftbobler som kommer inn i kretsl\u00f8pet<\/h3>\n\n\n\n<p>The team takes every precaution to keep clots or air from reaching the patient, which might result in catastrophic harm to the brain or lungs known as an embolism. A &#8220;bubble detector,&#8221; which may be included on some circuits, is a safety device that shuts the circuit when a bubble is &#8220;spotted&#8221; within the tube. The ECMO specialist can then remove the air before it affects the patient.<\/p>\n\n\n\n<h2>Dine vitenskapelige illustrasjoner treffer blink<\/h2>\n\n\n\n<p>Bruk et fantastisk verkt\u00f8y for \u00e5 legge til infografikk med relevante data i arbeidet ditt, og forbedre det med viktige visuelle elementer av h\u00f8y kvalitet. Mind The Graph ble utviklet for \u00e5 hjelpe det vitenskapelige milj\u00f8et ved \u00e5 tilby flere brukervennlige infografikkmaler.<\/p>\n\n\n\n<div style=\"height:17px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"is-content-justification-center is-layout-flex wp-container-2 wp-block-buttons\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link has-background wp-element-button\" href=\"https:\/\/mindthegraph.com\/science_figures\" style=\"border-radius:50px;background-color:#dc1866\" target=\"_blank\" rel=\"noreferrer noopener\">Start din f\u00f8rste vitenskapelige illustrasjon<\/a><\/div>\n<\/div>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Mind the Graph - Slik fungerer det: \u00e5 lage et grafisk sammendrag\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/AK7bH7Yq2gI?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<div style=\"height:25px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>L\u00e6r hva en VA ECMO er, hvordan den skiller seg fra VV ECMO, og hvordan den kan brukes til \u00e5 redde livet til mange pasienter i livstruende situasjoner.<\/p>","protected":false},"author":28,"featured_media":25530,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[959,28,956],"tags":[775,916],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>VA ECMO: What it is and how it may 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