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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

So, today’s tip is about, “Whether patients on ECMO (extracorporeal membrane oxygenation) in ICU need paralyzing agents or muscle relaxants?” Well, that’s a great question. It’s a question we get all the time when we have clients that are on ECMO and some of them are on paralytic agents or muscle relaxants, and some of them aren’t.

So, what’s the difference? When do patients in ICU need paralytics or muscle relaxants while they’re on ECMO? So, similar to some patients that are on a ventilator and need paralytics, they are often resisting the ECMO therapy. And if they are resisting ECMO therapy, the flow goes down and it starts alarming, and ECMO therapy cannot achieve what it needs to achieve. And what does ECMO therapy need to achieve? It needs to achieve either to replace the function of the heart or the lungs, in some situations, even both.

So therefore, ECMO really extracts blood from the body, puts it through an oxygenator like a bypass machine, and then puts oxygenated blood back into the body, but also removes carbon dioxide. So, imagine it takes over the function of the lung and of the heart and the patient does resist the ECMO therapy. And then obviously, the only option is for patients to be paralyzed.

It’s definitely not ideal because on top of an induced coma, you are also using paralytic agents. And from my experience, it takes even longer for patients to wake up after an induced coma and paralytics. So, there’s definitely an issue there, but it does happen every now and then in order to achieve the results of the ECMO therapy.

And also lastly, a lot of patients or a lot of families that have loved ones on ECMO are also being asked whether they should sign a DNR (do not resuscitate). And if you have watched any of my videos, you would know that we strictly advise against signing DNR or agreeing to end of life treatment. I’m not going into detail here. I’ve got plenty of videos about why people should not sign a DNR or why people should not agree to withdrawal of treatment.

So, that is my quick tip for today.

If you have a loved one in intensive care, go to intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected].

Also, have a look at our membership site for families in intensive care at intensivecaresupport.org. There, you have access to me and my team, 24 hours a day, in a membership area and via email, and we answer all things, intensive care related.

If you need a medical record review for your loved one while they’re in intensive care or after intensive care, you should contact us as well. But it’s best if you contact us while your loved one is in ICU. So, we can give you those crucial insights. We can give you the crucial questions to ask. We can ask the questions on your behalf. Obviously, I offer one-to-one consulting. I talk to doctors and nurses directly and ask questions either on your behalf or I can set you up with questions. That’s part of what we do.

Subscribe to my YouTube channel for regular updates for families in intensive care, share the video with your friends and families, click the like button, click the notification bell, and comment below what you want to see next, or what questions and insights you have from this video.

Thanks for watching.

This is Patrik Hutzel from intensivecarehotline.com and I’ll talk to you in a few days.