Transcripts
DR. CORNEL:
So at about 1:30, more like
2:30, really, I was able to assemble a group of
people and a machine and start the ECMO.
We used the left groin vessel,
to insert our tubes. We used a circuit coated
with (sorry to use a trade name,) Carmeda, it's
a heparin analogue that's bonded to the inside
of the circuitry. And it has some protective
effect on the blood and it reduces the level of
heparin that we have to give these patients. I
think in a desperate situation like this the
Carmeda made the difference.
We managed the renal failure by
ultrafiltration with a rather simple ultrafilter
in circuit on the bypass machine. And we
supplemented that with peritoneal dialysis.
We were able to obtain really
excellent circulation. The blood gas normalized,
the heart emptied out and got
dramatically smaller, as I will show you.
Everything looked better but we got a compartment
syndrome. The muscles in the left leg started
to swell. The leg muscles are enclosed
within fibrous sheathes that help them to work
more efficiently. But if the muscles swell
within those sheathes they've got no room to
expand so the pressure on them increases and the
blood can't flow into them. So the muscle will
die, (become gangrenous or necrotic).
