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

So, one of the questions we get quite frequently, especially when families have a loved one on ECMO in ICU for either heart failure or for lung failure, they’re asking, “Can my loved one have a tracheostomy while they’re on ECMO?” And that’s a great question. And again, a question that needs to be answered for families in intensive care.

So, when patients are on ECMO (extracorporeal membrane oxygenation), they are also, most of the time, on a medication called heparin. Heparin is a blood thinner because blood is being taken out of the body, and run through a filter. And where the gas exchange is taking place, meaning oxygen is being induced into the bloodstream and then into the body and carbon dioxide is removed, as similar to the function of the lung. Heparin needs to be used to prevent the blood from clotting, prevent thrombosis, and to prevent emboli.

So therefore, a patient on ECMO is at a fairly high risk of bleeding. The aPTT (activated partial thromboplastin time), which is the clotting factor in the blood needs to be monitored very closely, multiple times a day, when someone is on ECMO and heparin. Therefore, the risk for a tracheostomy is pretty high or to do a tracheostomy is pretty high. And it means, a tracheostomy in ECMO is a very high risk because of the risk for a significant bleed when doing the tracheostomy, because the tracheostomy is a surgical procedure.

So, the answer is really no. Only in very few exceptions have I seen a tracheostomy being done while on ECMO. Because otherwise, the risk is simply too high to do the tracheostomy while someone is on often high doses of heparin.

That is my quick tip for today.

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

Also, check out our membership for families in intensive care at intensivecaresupport.org.

We also provide medical record reviews for patients that are in ICU or if you have a loved one in intensive care, and you want to review the medical records after they’ve been in intensive care, it’s also a service that we provide.

I want you to share this video with your friends and families, especially if they have a loved one in intensive care, subscribe to my YouTube channel , give the video a thumbs up, give it a like and comment below what you want to see next or what questions and insights you have from this video, and click the notification bell.

Thank you so much for watching.

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

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