A 3 page discussion of the criteria that
are used to decide ventilation methodology and technique While ECMO is both an invasive and potentially dangerous therapeutic intervention, it is often warranted by patient condition. Bibliography lists 2 sources.
Name of Research Paper File: AM2_PPnrsVn2.rtf
Unformatted Sample Text from the Research Paper:
One of the more frequent choices for neonatal ventilation in particular is Extracorporeal Membrane Oxygenation (ECMO). There are, however, significant risks associated with
ECMO. It is an invasive and potentially dangerous therapy. Deciding which patients should undergo ECMO treatment, therefore, can be quite complicated. Deciding between ECMO and other therapeutic
approaches is in reality quite controversial at times. Synchronous Intermittent Mandatory Ventilation (SIMV), for example, offers numerous advantages to patients. Oakes (2000, 13) clarifies that SIMV reduces:
"antagonism between spontaneously generated and mechanically generated breaths"
When a patient is responding well to SIMV physicians and health care professional in general prefer to avoid the risks of an invasive
procedure like ECMO. Likewise, infants under the gestational age of 34 weeks seldom utilize therapeutic options like ECMO (University of Michigan Health System, 2005). The risks of morbidity
are simply too high (University of Michigan Health System, 2005). When an infant has a birthweight less than 2,000 grams ECMO is seldom an option as well (Oakes, 2000;
University of Michigan Health System, 2005). Although size alone is not an absolute contraindication to ECMO, the cannula size that is necessary for ECMO is often too large for
infants under 2,000 grams (University of Michigan Health System, 2005). Numerous other criteria direct that an infant remain on SIMV as
opposed to being treated with ECMO. Significant coagulopathy, uncontrollable bleeding, and intracranial hemorrhage are limiting factors as is the length of time an infant has been on mechanical ventilation (Oakes,