Troubleshooting: Air in the Circuit:

Air in the ECMO circuit can have devastating complications, including embolization and ischemia, as well as complete circuit standstill.

It is important to realize that air in the ECMO circuit does not usually look like discrete bubbles. Instead it looks like "froth".

If there is a small amount of air in the circuit:

  • This will not cause the circuit to malfunction, but it should be removed immediately.
  • Try to vent the air by removing the yellow cap on the venous side of the oxygenator (this is sometimes called "burping" the circuit).
  • Try to identify the source of the air.

If there is a large amount of air in the circuit:

  • This is an emergency, as an "air lock" can cause flow to arrest in the circuit.
  • Call for help immediately.
  • Try to vent the air by "burping the circuit", but if there is an air lock, this will not help.
  • Do not clamp or cut any tubing until a plan has been made to replace the circuit, and all the necessary equipment and personnel are immediately available.

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