Training the component steps of an extra-corporeal membrane oxygenation (ECMO) cannulation outside the clinical setting
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ORIGINAL ARTICLE Artificial Lung / ECMO
Training the component steps of an extra‑corporeal membrane oxygenation (ECMO) cannulation outside the clinical setting Sanne M. B. I. Botden1 · Guus M. Bökkerink1,2 · Erik Leijte1 · Tim Antonius3 · Ivo de Blaauw1 Received: 18 November 2019 / Accepted: 12 May 2020 © The Author(s) 2020
Abstract Extra-corporeal membrane oxygenation (ECMO) cannulation can be a stressful procedure because a fast cannulation is vital for the patient’s survival. Therefore, it is important to train the steps of cannulation outside the clinical setting. A relatively low budget, easy to use model, was developed to train the most important steps of an ECMO cannulation. Following this, it was evaluated by experts and target group participants. They all completed a questionnaire regarding their experience and opinions on the ECMO model on general aspects and the training of the component steps, rated on a 5-point Likert scale. Twenty-one participants completed the questionnaire. The features and steps of the model were rated with a mean of 3.9 on average. The haptics of the landscape scored least, with a mean of 3.6, although the haptics of the vessels scored highest with 4.0. The rating of the component steps showed that only ‘opening of the vessels’ was scored significantly different between the expertise levels (means experts: 4.0, target group: 3.4, p = 0.032). This low budget model is considered to be a valid tool to train the component steps of the ECMO cannulation, which could reduce the learning curve in the a stressful clinical setting. Level of evidence: II prospective comparative study. Keywords Extra-corporeal membrane oxygenation · Training · Simulation · Artificial model Abbreviation ECMO Extra-corporeal membrane oxygenation
Introduction Extra-corporeal membrane oxygenation (ECMO) is an intervention carried out on patients who are in a life-threatening situation due to pulmonary and/or cardiac failure. The initiation of ECMO is time critical, as is the ongoing management of these patients, because any issue during the therapy can irreversibly compromise the patient’s outcome. The use of
* Sanne M. B. I. Botden [email protected] 1
Department of Pediatric Surgery, Radboudumc – Amalia Children’s Hospital, Route 618, PO Box 9101, 6500 HB Nijmegen, The Netherlands
2
Department of Pediatric Surgery, Princess Maxima Center, Utrecht, The Netherlands
3
Department of Neonatology, Radboudumc – Amalia Children’s Hospital, Nijmegen, The Netherlands
ECMO in children and neonates is limited to centers which have the opportunity to perform this treatment. Fortunately, ECMO is not necessary in pediatric patients very often, although this makes it a relatively rare procedure for pediatric (cardiac) surgeons, which has to be performed during a resuscitation and sometimes even reanimation setting. The cannulation of an unstable neonate or infant on extracorporeal membrane oxygenation (ECMO) can be a stressful procedure for a surgeon. Although the dissection of the vessels is not
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