Extracorporeal membrane oxygenation (ECMO) has a few basic parts: an inflow (“drainage”) cannula, mechanical blood pump, membrane oxygenator, heat exchanger, and an outflow (“return”) cannula. In a motor failure, pump flow can be maintained via a hand crank while troubleshooting the problem.
To do this, the patient is emergently taken off ECMO by clamping the inflow and outflow cannulas. Since the patient is on ECMO for a reason (and you transiently interrupted it), the operator must provide full ventilation and hemodynamic support (pressors, inotropes) in the interim. Next, the pump head is moved to the emergency drive unit (pictured). The cannulas are unclamped. The operator begins hand-cranking while monitoring the ECMO pump speed, flow, and overall hemodynamics.
Although I’ve never actually seen this utilized in person, this crank is a backup option for both ECMO and cardiopulmonary bypass (CPB).
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