Thursday December 20, 2007
Bedside tip - ECMO and lipid infusion

If you have a patient receiving extracorporeal membrane oxygenation (ECMO), TPN * should be instituted WITHOUT IV lipids. IV lipid emulsion increases the incidence of layering out, agglutination, or clot formation during ECMO. This may result in disruption of normal ECMO blood flow.

* TPN = Total Parenteral Nutrition


Related previous pearls: ECMO, ABGs while patient on ECMO

Important trial to watch: Multicenter CESAR trial - (Conventional ventilation or ECMO for Severe Adult Respiratory Failure - 180 patients) - The first international presentation of the results will be presented at the Society of Critical Care Medicine's 37th Critical Care Congess in Hawaii, February 2008.



References :

1. Comparison of methods for intravenous infusion of fat emulsion during extracorporeal membrane oxygenation . Pharmacotherapy 2005;25(11):1536-1540