Teknik ECMO & ECPR

Oleh :

dr.Nailla Fariq Alfiani

Teknik Extracorporeal Membrane Oxygenation (ECMO) dilakukan dengan kanulasi vaskular (veno-arterial atau veno-venous) untuk mengalirkan darah ke sirkuit eksternal yang menyediakan oksigenasi dan dukungan sirkulasi sesuai kebutuhan klinis. Extracorporeal Cardiopulmonary Resuscitation (ECPR) merupakan penerapan ECMO pada pasien henti jantung refrakter, yang dimulai bersamaan dengan resusitasi kardiopulmoner untuk menggantikan fungsi jantung dan paru sementara.[2,3,5,12]

Persiapan Pasien

Persiapan pasien untuk ECMO meliputi stabilisasi awal, penilaian fungsi organ, pemeriksaan laboratorium lengkap termasuk koagulasi, serta pemilihan strategi kanulasi yang sesuai dengan kondisi klinis. Pada ECPR, persiapan difokuskan pada akses vaskular cepat, dukungan resusitasi lanjutan yang optimal, serta koordinasi tim multidisiplin untuk meminimalkan waktu low-flow sebelum inisiasi ECMO.[2,6,8,10]

Referensi

1. Inoue A, Hifumi T, Sakamoto T, Kuroda Y. Extracorporeal Cardiopulmonary Resuscitation for Out‐of‐Hospital Cardiac Arrest in Adult Patients. Journal of the American Heart Association. 2020. Volume 9, Issue 7. https://doi.org/10.1161/JAHA.119.015291
2. Richardson ASC, Tonna JE, Nanjayya V, Nixon P, et al. Extracorporeal Cardiopulmonary Resuscitation in Adults. Interim Guideline Consensus Statement From the Extracorporeal Life Support Organization. ASAIO journal (American Society for Artificial Internal Organs : 1992), 2021. 67(3), 221–228. https://doi.org/10.1097/MAT.0000000000001344
3. Wengenmayer T, Tigges E, Staudacher DL. Extracorporeal cardiopulmonary resuscitation in 2023. ICMx, 2023. 11, 74. https://doi.org/10.1186/s40635-023-00558-8
5. Rabah H, Rabah A. Extracorporeal Membrane Oxygenation (ECMO): What We Need to Know. Cureus, 2022. 14(7), e26735. https://doi.org/10.7759/cureus.26735
6. Abrams D, Fried J, Agerstrand B. Extracorporeal Life Support in Adult: Management of Venoarterial Extracorporeal Membrane Oxygenation (V-A ECMO). Uptodate. 2025. https://www.uptodate.com/contents/extracorporeal-life-support-in-adults-management-of-venoarterial-extracorporeal-membrane-oxygenation-v-a-ecmo#H2957126972
7. Kawauchi A, Makoto A, Ogaswara T, et al. Evaluating The Impact of ELSO Guideline Adherence on Favorable Neurological Outcomes Among Patients Requiring Extracorporeal Cardiopulmonary Resuscitation for Out-of-Hospital Cardiac Arrest. Elsevier Resuscitation 199, 2024. 110218. doi: 10.1016/j.resuscitation.2024.110218.
8. Harnisch LO, Moerer O. Contraindications to the Initiation of Veno-Venous ECMO for Severe Acute Respiratory Failure in Adults: A Systematic Review and Practical Approach Based on the Current Literature. Membranes, 2021. 11(8), 584. https://doi.org/10.3390/membranes11080584
10. Rizvi S, Nagle M, Roberts B, et al. Cardiac Extracorporeal Membrane Oxygenation in Community Cardiac Surgery Program: Are the Results Comparable?. Cureus, 2024. 16(4): e58947. DOI 10.7759/cureus.58947.
12. Kang JK, Darby Z, Bleck TP, et al. Post-Cardiac Arrest Care in Adult Patients After Extracorporeal Cardiopulmonary Resuscitation. Critical care medicine, 2024. 52(3), 483–494.
13. Pooboni SK, Gulla KM. Vascular access in ECMO. Indian journal of thoracic and cardiovascular surgery, 2021. 37(Suppl 2), 221–231. https://doi.org/10.1007/s12055-020-00999-w
14. UCSF Health medical specialists. Extracorporeal Membran Oxygenation (ECMO). 2025. https://www.ucsfhealth.org/treatments/extracorporeal-membrane-oxygenation
15. Vyas A, Bishop MA. Extracorporeal Membrane Oxygenation in Adults. StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK576426/
16. Alfred Health. ECMO Guidelines. 2025 https://ecmo.icu/safety-essentials-equipment-used/#
17. Edecmo. Equipment Choices ECMO. 2025. https://edecmo.org/equipment-choices/
18. Multimedia Manual of Cardio-Thoracic Surgery. Venovenous Extracorporeal Membrane Oxygenation Neck Cannulation in An Infant. 2025. https://mmcts.org/tutorial/1869

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Masuk atau Daftar

Nomor Ponsel Sudah Terdaftar

Masuk dengan Email

Masuk dengan Email

Masuk dengan Facebook

Teknik ECMO & ECPR

Referensi

Masuk atau Daftar

Artikel Terkait