Troubleshooting: Pump Failure:
This is an extremely rare but devastating complication, and the patient can die very quickly if this isn't managed properly. Before troubleshooting pump failure, call for help from the perfusionist, ICU staff and surgical staff immediately!
There are three main reasons the pump will fail:
- Insufficient power provided to turn the motor of the centrifugal pump.
- Malfunction of the motor itself.
- Displacement of the centrifugal impeller.
Power Failure
Power failure results from:
- A dead battery when transporting a patient.
- A power failure in the building.
Motor Malfunction
Motor malfunction is extremely rare, but if it occurs:
- An alarm on the ECMO circuit will signal that the motor is malfunctioning.
- The motor will need to be replaced with a new circuit, which is kept on standby in the ICU.
- There is no manual hand crank available.
Centrigugal Impeller Displacement
Centrifugal impeller displacement is extremely rare, but if it occurs:
- Call for help (ask for an overhead call for perfusion stat to the room you are in).
- Turn the pump flow off.
- Temporarily clamp the venous line.
- If the surgical team and perfusionist can successfully reposition the centrifugal pump, then unclamp the venous line and slowly increase flows.
- If the pump cannot be fixed, it must be replaced immediately.
- If the patient is on V-A ECMO, administer CPR if necessary.