The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment
<b>Background:</b> 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 b...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/13/5/1292 |
| _version_ | 1797264305988567040 |
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| author | Franz Haertel Mirko Kaluza Jurgen Bogoviku Julian Westphal Michael Fritzenwanger Ruediger Pfeifer Daniel Kretzschmar Torsten Doenst Sven Moebius-Winkler P. Christian Schulze |
| author_facet | Franz Haertel Mirko Kaluza Jurgen Bogoviku Julian Westphal Michael Fritzenwanger Ruediger Pfeifer Daniel Kretzschmar Torsten Doenst Sven Moebius-Winkler P. Christian Schulze |
| author_sort | Franz Haertel |
| collection | DOAJ |
| description | <b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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. |
| first_indexed | 2024-04-25T00:26:48Z |
| format | Article |
| id | doaj.art-986e13bb280c4c539951f139e6d24556 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-04-25T00:26:48Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-986e13bb280c4c539951f139e6d245562024-03-12T16:47:52ZengMDPI AGJournal of Clinical Medicine2077-03832024-02-01135129210.3390/jcm13051292The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room DeploymentFranz Haertel0Mirko Kaluza1Jurgen Bogoviku2Julian Westphal3Michael Fritzenwanger4Ruediger Pfeifer5Daniel Kretzschmar6Torsten Doenst7Sven Moebius-Winkler8P. Christian Schulze9Department of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Cardiothoracic Surgery, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyHeart and Vascular Medicine (HUGG), Fleischscharren 4, 38642 Goslar, GermanyDepartment of Cardiothoracic Surgery, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, GermanyDepartment of Internal Medicine I, Cardiology, University Hospital Jena, Am Klinikum 1, 07747 Jena, Germany<b>Background:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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.https://www.mdpi.com/2077-0383/13/5/1292ECMOECLSprimed circuitwet circuitcardiac resuscitationlow cardiac output support |
| spellingShingle | Franz Haertel Mirko Kaluza Jurgen Bogoviku Julian Westphal Michael Fritzenwanger Ruediger Pfeifer Daniel Kretzschmar Torsten Doenst Sven Moebius-Winkler P. Christian Schulze The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment Journal of Clinical Medicine ECMO ECLS primed circuit wet circuit cardiac resuscitation low cardiac output support |
| title | The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment |
| title_full | The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment |
| title_fullStr | The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment |
| title_full_unstemmed | The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment |
| title_short | The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room Deployment |
| title_sort | jena method perfusionist independent standby wet primed extracorporeal membrane oxygenation ecmo circuit for immediate catheterization laboratory and or hybrid operating room deployment |
| topic | ECMO ECLS primed circuit wet circuit cardiac resuscitation low cardiac output support |
| url | https://www.mdpi.com/2077-0383/13/5/1292 |
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