Patient Care During ECMO

Patient care during ECMO includes daily nursing and a careful head-to-toe examination to assess organ functions, reveal actual problems and draw the daily care plan. Nursing care should take into account the risks related to anticoagulation and the presence of ECMO equipment. Neurological evaluation, need and depth of sedation, assessment of effective protective ventilation and timing for weaning, haemodynamic assessment, infective status, bowel function and nutritional support and hepatic and renal function are the key points in the standard head-to-toe examination of the ECMO patients. The complex interaction between the patient and the ECMO apparatus must be accounted during the evaluation. Finally, complications such as bleeding and pneumothorax should be promptly recognised and treated; to minimise the risk of bleeding, a “do no harm” approach must be used avoiding unnecessary invasive procedures.