|
|
詳述ECMO的流程與使用方式、注意事項等。
再版序
第一篇 概論 .................................................. 1
第一章 體外循環維生系統概論................................. 3
第二章 小兒ECMO的臨床應用.............................. 37
第二篇 Protocol and Record Form ....................... 45
第一章 Equipment ................................................ 47
1. ECMO Equipmen .................................................... 47
2. ECMO Cart .............................................................. 60
3. ECMO Warehouse .................................................... 63
4. Distal Perfusion Catheter .......................................... 66
5. ECMO Operation Instrument Box（PCV-13） ........... 69
6. ECMO機器電池使用標準作業規範 ........................ 73
7. ECMO水箱操作及注意事項 .................................. 76
8. Medtronic ECMO機器維修標準作業規範 .............. 79
第二章 Preparation and Priming ....................... 83
1. ECMO照會前需知 ................................................. 83
2. 手術排程 ................................................................. 88
3. Medtronic Centrifugal ECMO Machine Setting ........ 95
4. Medtronic Centrifugal ECMO Circuit Priming- Adult
................................................................................... 99
5. Maquet Rota Flow 機器操作設定程序 .................. 102
vi
6. Maquet Medos ECMO Circuit Priming- Adult ........ 105
7. Maquet PLS-i System Priming Procedure ............... 108
8. Centrifugal ECMO Priming- Pediatric .................... 115
9. Whole ECMO Circuit Exchange ............................. 118
10. MEDOS Adult Oxygenator Exchange ..................... 122
第三章 Cannulation and Removal ................... 125
1. Pediatric V-A ECMO Neck Cannulation .................... 125
2. Pediatric ECMO Transthoracic Cannulation ............. 128
3. Adult V-A ECMO Femoral Cannulation .................. 130
4. Adult ECMO Axillary Cannulation .......................... 133
5. Adult Femoral V-A ECMO Weaning and Removal .. 136
6. V-V ECMO ............................................................ 140
7. ECMO Shift to CPB Algorithm ............................... 153
8. ECMO管路緊急更換流程 .................................... 156
第四章 ECMO Mode .................................. 159
第五章 Care ............................................. 173
1. ECMO Care Guideline ............................................ 173
2. 活化凝血時間測量 ................................................ 180
2-1 HEMOCHRON® ResponseACT機器定期保養
校正程序 ......................................................... 183
3. Serum Free Hemoglobin Measurement by HemoCue
.............................................................................. 185
4. CAVH on ECMO .................................................... 187
4-1. Fresenius 5008 SLEDD-f on ECMO ................ 190
5. SICU Bedside Operation Order ............................... 196
vii
6. 血氧飽合度監測器校正 ........................................ 197
7. Pressure Calibration and Monitor ............................ 199
8. 撤除ECMO維生系統之關機程序 ....................... 201
8-1. 生命末期病人撤除ECMO Check List ........... 203
9. ECMO遇緊急災害之應變措施 ............................ 204
10. 體外維生系統（ECMO）家屬衛教單 ................. 206
第六章 Special ......................................... 209
1. ECMO病人院內運送流程 .................................. 209
2. ECMO for Lung Transplantation ........................... 212
3. NTUH NHBD ECMO Protocol ............................. 214
4. ECMO for CPCR Guideline ................................... 218
5. Hypothermia after ECPR ........................................ 220
6. AV CO2-R Protocol ................................................ 222
7. VV CO2-R Protocol ................................................ 225
8. Check List for Brain Death of ECMO Patient .......... 228
第七章 外院轉診運送 ................................. 259
1. 體外循環維生系統病患之運送概論 ..................... 259
2. ECMO轉診運送的交通工具 ................................. 235
2-1 體外循環維生系統轉運救護車之需求設備 .... 235
2-2 ECMO高鐵運送標準作業流程 ....................... 238
2-3 ECMO SOS運送標準作業流程 ....................... 241
3.轉診運送的流程 ..................................................... 244
3-1 外院ECMO病患轉入本院SICU之流程 ......... 244
3-2 台北市救護車運送標準收費表 ...................... 245
3-3 不明原因ARDS之ECMO轉運流程 ............... 247
3-4 準備用物Check List ........................................ 249
3-5救護車出發前Check List ................................ 251
3-6 ECMO返院前Check List ................................ 252
3-7 返院途中救護車上ECMO Check List ............ 253
3-8 加護病房接收外院ECMO Check List ............ 254
第八章 健保規範 ...................................... 255
1. ECMO使用適應症 ................................................. 255
2. 心室輔助器裝置植入適應症 .................................. 257
3. CentriMag事前審查申請書 .................................... 258
4. 線上申請CentriMag流程 ....................................... 259
第九章 Record Form .................................... 265
-病歷單張 .................................................................. 265
1. 體外循環維生系統手術說明暨同意書 .................. 266
2. 麻醉說明暨同意書 .................................................... 269
3. 體外循環維生系統轉診同意書 .............................. 273
4. 體外循環維生系統裝置前評估單 .......................... 275
5. 體外循環維生系統裝置記錄單.............................. 277
6. 成人體外循環維生系統裝置後照護計畫單 ........... 278
7. 小兒體外循環維生系統裝置後照護計畫單 ........... 280
8. 體外循環維生系統裝置檢查清單 .......................... 281
9. 體外循環維生系統每日檢查清單 .......................... 282
10. 體外維生系統及生命徵象記錄單 .......................... 283
11. 體外循環維生系統外院轉診紀錄單 ...................... 284
12. 復甦術使用體外循環維生系統紀錄單 .................. 286
13. NTUH ECMO Operation Consumables Record
(耗材記帳單) ............................................................. 288
ix
-資料庫單張.............................................................. 289
14. NTUH ECMO Database Registry Record ................ 290
15. NTUH AMI ECMO Record ..................................... 296
16. NTUH ARDS ECMO Record .................................. 299
17. NTUH Lung Transplantation ECMO Record ............ 300
18. NTUH NHBD ECMO Record .................................. 301
19. ELSO Registry Form ................................................ 302
20. ELSO Cardiac Addendum Form ............................... 307
21. ELSO ECPR Addendum Form ................................. 309
22. 照會拒絕體外循環維生系統評估單 ....................... 312
第十章：案例分析 ....................................... 313
1. Oxygenator Thrombus .............................................. 314
2. Cannula 問題 .......................................................... 316
3. Hypothemia ............................................................. 326
4. Aortic Root Thrombus .............................................. 329
5. BP與IABP之關係 ................................................ 333
6. ECMO Shift to LVAD之理想時機 ......................... 335
7. LVAD Candidate ..................................................... 339
8. ECMO Transport CPR .............................................. 343
9. Delay ECMO Support in a AMI Patient with Cardiogenic Shock...................................................................... 345
10. 第二台ECMO時機 ............................................... 347
11. ECMO Mode ........................................................... 351
12. ECMO in Lung Transplantation ............................... 355
13. Heparin Titration ..................................................... 357
14. ICH Complication .................................................... 360
第十一章：ECMO Publication Paper ......................... 363
第三篇 ECMO學習護照
（ECMO 教學PPT檔作成光碟）
第四篇 PDF of ECMO Publication by NTUH SICU
（PDF檔作成光碟）
