Patients on ECMO must be managed in

Patients on ECMO must be managed in an intensive care environment. In addition to the specific elements monitored thecircuit(see Chaper3), standard ICU continuous monitoning is routinely used. Bedside observations by a trained nurse are vital. These observations should encompass both patient and circuit. Continuous awareness of the potential issues is important,as a rapid response to events is required to avoid catastrophic consequences. Standard monitoring will include, but not be restricted to, continuous cardiac rhythm monitoring, pulse oximetry, invasive arterial and venous blood pressures, temperature,respiratory rate and end-tidal CO2. These will be documented at regular intervals. Hourly observations will include fluid intake and output, and the overall fluid balance will be calculated. Circuit data will also bedocumented. Intravascular pressure can be measured in the same way as in non-ECMO patients. Of note, any indwelling venous catheter is a potential source of air that could be entrained into the ECMO circuit due to the high negative pressure