Ecmo babies

[dcharland]

How do you all keep up with ecmo baby blood product requests? We are new at this and we had a baby this weekend requiring 120cc's at a time in syringes. Presetnly our syringes expire in 4 hours so we don't make them up ahead of time.

[BSIPHERD]

What size syringe do you use? I know there are 60 cc syringes available. Also, I believe that for Charter Med syringes, their package insert states that a 24 hour expiration can be used for red cells in the syringe.

[shelleyk482]

I worked at 2 facilities that did neonatal/infant ECMO. At both places, we provided blood in an aliquot bag rather than a syringe. We would pre-aliquot bags usually in 100 cc aliquots (depending on the size of the infant). I agree that you need to determine what the expiration of the RBCs should be; I've always used CharterMed and they specify 24 hours as long as the syringe is stored at the proper temperature.

[jmphil4]

At our facility, we split a whole unit into quad bags. We also have a cooler (rated for 12 hrs) at the pt bedside. They usually keep about 4 quads in the cooler and we keep 4 more in the blood bank ready to go. Every 12 hrs we switch out the ice, and replenish the blood as needed. We thaw the plasma/cryo and get platelets ready when requested.

At the bedside they spike the quads and pull off what they need into a syringe.

[dmpollock]

What kind of cooler is the one rated at 12 hours?

[jmphil4]

We use the igloo coolers with three bags (5 lbs each) of crushed ice. We place the blood (or plasma) between the top and middle bags. Each cooler holds up to 4 whole units of blood.