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详述ECMO的流程与使用方式、注意事项等。

再版序

第一篇 概论 .................................................. 1
第一章 体外循环维生系统概论................................. 3
第二章 小儿ECMO的临床应用.............................. 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机器电池使用标准作业规范 ........................ 73
7. ECMO水箱操作及注意事项 .................................. 76
8. Medtronic ECMO机器维修标准作业规范 .............. 79

第二章 Preparation and Priming ....................... 83
1. ECMO照会前需知 ................................................. 83
2. 手术排程 ................................................................. 88
3. Medtronic Centrifugal ECMO Machine Setting ........ 95
4. Medtronic Centrifugal ECMO Circuit Priming- Adult
................................................................................... 99
5. Maquet Rota Flow 机器操作设定程序 .................. 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管路紧急更换流程 .................................... 156

第四章 ECMO Mode .................................. 159

第五章 Care ............................................. 173
1. ECMO Care Guideline ............................................ 173
2. 活化凝血时间测量 ................................................ 180
2-1 HEMOCHRON® ResponseACT机器定期保养
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. 血氧饱合度监测器校正 ........................................ 197
7. Pressure Calibration and Monitor ............................ 199
8. 撤除ECMO维生系统之关机程序 ....................... 201
8-1. 生命末期病人撤除ECMO Check List ........... 203
9. ECMO遇紧急灾害之应变措施 ............................ 204
10. 体外维生系统（ECMO）家属卫教单 ................. 206

第六章 Special ......................................... 209
1. ECMO病人院内运送流程 .................................. 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 外院转诊运送 ................................. 259
1. 体外循环维生系统病患之运送概论 ..................... 259
2. ECMO转诊运送的交通工具 ................................. 235
2-1 体外循环维生系统转运救护车之需求设备 .... 235
2-2 ECMO高铁运送标准作业流程 ....................... 238
2-3 ECMO SOS运送标准作业流程 ....................... 241
3.转诊运送的流程 ..................................................... 244
3-1 外院ECMO病患转入本院SICU之流程 ......... 244
3-2 台北市救护车运送标准收费表 ...................... 245
3-3 不明原因ARDS之ECMO转运流程 ............... 247
3-4 准备用物Check List ........................................ 249
3-5救护车出发前Check List ................................ 251
3-6 ECMO返院前Check List ................................ 252
3-7 返院途中救护车上ECMO Check List ............ 253
3-8 加护病房接收外院ECMO Check List ............ 254

第八章 健保规范 ...................................... 255
1. ECMO使用适应症 ................................................. 255
2. 心室辅助器装置植入适应症 .................................. 257
3. CentriMag事前审查申请书 .................................... 258
4. 线上申请CentriMag流程 ....................................... 259

第九章 Record Form .................................... 265
-病历单张 .................................................................. 265
1. 体外循环维生系统手术说明暨同意书 .................. 266
2. 麻醉说明暨同意书 .................................................... 269
3. 体外循环维生系统转诊同意书 .............................. 273
4. 体外循环维生系统装置前评估单 .......................... 275
5. 体外循环维生系统装置记录单.............................. 277
6. 成人体外循环维生系统装置后照护计画单 ........... 278
7. 小儿体外循环维生系统装置后照护计画单 ........... 280
8. 体外循环维生系统装置检查清单 .......................... 281
9. 体外循环维生系统每日检查清单 .......................... 282
10. 体外维生系统及生命征象记录单 .......................... 283
11. 体外循环维生系统外院转诊纪录单 ...................... 284
12. 复甦术使用体外循环维生系统纪录单 .................. 286
13. NTUH ECMO Operation Consumables Record
(耗材记帐单) ............................................................. 288
ix
-资料库单张.............................................................. 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. 照会拒绝体外循环维生系统评估单 ....................... 312

第十章：案例分析 ....................................... 313
1. Oxygenator Thrombus .............................................. 314
2. Cannula 问题 .......................................................... 316
3. Hypothemia ............................................................. 326
4. Aortic Root Thrombus .............................................. 329
5. BP与IABP之关系 ................................................ 333
6. ECMO Shift to LVAD之理想时机 ......................... 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时机 ............................................... 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学习护照
（ECMO 教学PPT档作成光碟）

第四篇 PDF of ECMO Publication by NTUH SICU
（PDF档作成光碟）

None

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