72 Hours Standby Time of Wet-Primed Cardiopulmonary Bypass Circuits: A Microbiological Quality Assurance Study

Schulz-Stübner, Sebastian; Schorer, C.; Ennker, Jürgen; Bauer, Stefan; Schaumann, Reiner

doi:10.1055/s-0034-1371698

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…The sterility of the primed circuits is another important consideration in ECMO/ECLS programs. The current recommendations from ELSO/Euro ELSO [12] and the corresponding literature support the fact that primed circuits are hygienically uncritical for defined periods of time [6,[8][9][10], and we have not encountered any issues with circuit sterility. However, we recommend discarding the system after a maximum of 28 days.…”

Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

“…Several studies have investigated the efficacy and safety of wet priming in ECMO deployment [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. It was shown that a pre-primed circuit can maintain adequate function for up to two weeks on standby [ 9 ]. Another investigation demonstrated the feasibility of using pre-primed circuits in neonatal ECMO, with improved response times and reduced risk of circuit contamination [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment

Haertel,

Kaluza,

Bogoviku

et al. 2024

JCM

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Background: The timely initiation of extracorporeal membrane oxygenation (ECMO) is crucial for providing life support. However, delays can occur when perfusionists are not readily available. The Jena Method aims to address this issue by offering a wet-primed ECMO system that can be rapidly established without the perfusionist’s presence. Methods: The goal was to ensure prompt ECMO initiation while maintaining patient safety. The method focuses on meeting hygienic standards, safe primed storage of the circuit, staff training, and providing clear step-by-step instructions for the ECMO unit. Results: Since implementing the Jena Method in 2015, 306 patients received VA-ECMO treatment. Bacterial tests confirmed the sterility of the primed ECMO circuits during a 14-day period. The functionality of all the components of the primed ECMO circuit after 14 days, especially the pump and oxygenator, were thoroughly checked and no malfunction was found to this day. To train staff for independent ECMO initiation, a step-by-step system involves safely bringing the ECMO unit to the intervention site and establishing all connections. This includes powering up, managing recirculation, de-airing the system, and preparing it for cannula connection. A self-developed picture-based guide assists in this process. New staff members learn from colleagues and receive quarterly training sessions by perfusionists. After ECMO deployment, the perfusionist provides a new primed system for a potential next patient. Conclusions: Establishing a permanently wet-primed on-demand extracorporeal life support circuit without direct perfusionist support is feasible and safe. The Jena Method enables rapid ECMO deployment and has the potential to be adopted in emergency departments as well.

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Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment

Haertel,

Kaluza,

Bogoviku

et al. 2024

JCM

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Infektionsprävention und -früherkennung in der Zentralen Notaufnahme (ZNA): Vom Einzelfall bis zur Pandemie

Schulz-Stübner¹

2021

Krankenhaushygiene up2date

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Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems

Winnersbach,

Wallraff,

Schadow

et al. 2024

ASAIO Journal

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According to the Extracorporeal Life Support Organization (ELSO) guidelines, pre-assembled and already primed extracorporeal membrane oxygenation (ECMO) systems can be safely stored for up to 30 days under specific conditions. This study gives a detailed overview of existing pre-assembly practices. An anonymous online survey was conducted among chief perfusionists at German ECMO centers. Forty-four of a total of 83 ECMO centers (53%) completed the survey. Thirty-three percent do not preassemble ECMO systems. Seventy-seven percent (n = 34) reported having preassembled ECMO systems readily available (30% dry preassembly/20% wet preassembly/27% wet preassembly with circulation). Half of the participating centers (50%) reported having a standard operating procedure (SOP) and the majority (57%) of chief perfusionists expressed a need for an evidence-based SOP. A maximum storage time for wet preassembled ECMO systems is established in 88% of departments. On average, wet preassembled systems are discarded after 20 days, which is below the ELSO’s safe limit of 30 days. Overall, this survey reveals a heterogeneous approach regarding the practice of provisioning preassembled ECMO systems. The demand for an evidence-based SOP for the preassembly and storing of ECMO systems becomes evident, necessitating the determination of hygienic standards, regular training, and a reliable maximum storage period.

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72 Hours Standby Time of Wet-Primed Cardiopulmonary Bypass Circuits: A Microbiological Quality Assurance Study

Cited by 5 publications

References 5 publications

The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment

The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment

Infektionsprävention und -früherkennung in der Zentralen Notaufnahme (ZNA): Vom Einzelfall bis zur Pandemie

Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems

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