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Volume 3 Journal of Nursing Research and Practice Nursing & Pediatrics 2019
February 25-26, 2019
Page 13
February 25-26, 2019 | London, UK
5 th World Congress on Neonatology and Pediatrics
World Congress on Nursing Research and Evidence Based Practice
&
Monika Tukacs, J Nursing Research and Practice
Volume 3
Monika Tukacs
Columbia University Irving Medical Center, USA
Extubation during extracorporeal membrane oxygenation therapy in adults: A qualitative study on
experts’ perceptions
Statement of the Problem: Extracorporeal
membrane oxygenation (ECMO) is a
modification of intraoperative cardiopulmonary
bypass used in adults for severe cardiac,
cardiopulmonary or respiratory failure. Used
as salvage therapy for decades, its application
proliferated fourfold, and the number of
ECMO centers threefold over the past 10 years.
1 Additionally, while invasive mechanical
ventilation (IMV) during ECMO therapy has
been the mainstay in airway management, the
practiceof liberation fromit is growing, especially
as removal of the endotracheal tube (extubation).
2, 3 However, the timing and the process leading
to extubation remains a conundrum. 4, 5
Moreover, the literature lacks any extubation
guidelines applicable for ECMO in adults and is scarce for the rising need of clinicians. 5 The aim of this study was to better
understand perceptions of expert clinicians regarding extubation during ECMO in adults, and utilization of a guideline/algorithm.
Methodology & Theoretical Orientation: A qualitative study was utilized, including purposeful sampling, a homogeneous
approach and focus group discussions. It was conducted at an international conference with a dedicated focus group room at
the conference venue. Discussions were recorded and transcribed verbatim, followed by qualitative content analysis performed
concurrently and independently by both co-researchers.
Findings: Participation in this study was global and included experts in ECMO. Experts described managing airway during
ECMO differently and having difficulties in achieving extubation. Of the ten themes identified, two were the main focus of
discussions: extubation guideline and work culture. Fifteen percent of experts reported having a guideline, and all described it
as desired. The culture was labelled to be powerful with variations in approach to extubation during ECMO.
Conclusion & Significance: Experts unanimously agree on the usefulness of an Extubation guideline/algorithm for the majority of
ECMO patients. The study suggests collecting data on evidence-based practice, as a prospective cohort research study.
Biography
Monika Tukacs has her expertise in extracorporeal membrane oxygenation (ECMO), its physiology and clinical application, and is passionate about evidence-based
research in ECMO. Her pioneering in early recognition of the importance of liberating from invasive mechanical ventilation during ECMO is fundamental. The paucity in
literature has led her to perform a qualitative study on experts’ perceptions about ECMO and Extubation in adult patients. This ground-breaking investigation has already
raised an interest of researchers internationally. She has recently been asked to join in developing and conducting a multi-center prospective research study on the topic.
Her contribution to this innovative application of ECMO therapy trailblazes the path towards the future of contemporary ECMO