What a fantastic hospital and clinical site. I wish all of my fellow class mates could have the experiences that I have had at Washington Hospital Center(WHC). First week was ECMO, third week got to pump a heart transplant and today we got to participate in putting someone on ECCOR (extra corporeal carbon dioxide removal). Much of the principles are the same as ECMO but some very big differences in the circuit. There is no pump. The patients heart is the driving force for the circuit. The circuit come out of the patients femoral artery and goes through an oxygenator and then returns to the patient. The major function is to remove CO2. The patient that we had today came in with a pCO2 of 86. We were on ECCOR for 10 minutes and the blood gas returned and the pCO2 was at 46. It was quit a site to see.
There were some other issues involved. The doctor that did the cannulation hadn't ever done it before and had two residents helping him. Lets just say 2 hours later and a blood loss of 500cc we were ready to go. If only they called in one of the cardiac surgical assistants they would have been in, cannulated, and on ECCOR within 20 min, and a blood loss of about 50cc. But I guess it is their opportunity to learn. This was the first ECCOR that was performed at WHC and was exciting to see.
My advice to students is continue to be familiar with all of the things presented in classes because you never know when you will see it and everyone will be looking at the perfusionist to know if its right or not. Having a general idea of how it works really help me learn more about it as it was done.
--Gregory Kitchen
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