Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age
CPT4 code
Name of the Procedure:
Extracorporeal Membrane Oxygenation (ECMO)/Extracorporeal Life Support (ECLS) - Removal of Peripheral (Arterial and/or Venous) Cannula(e), Open, Birth through 5 Years of Age
Summary
This procedure involves the removal of tubes (cannulae) that were previously inserted into a child's blood vessels to provide mechanical support to their heart and lungs.
Purpose
This procedure is performed to safely remove the cannulae after the need for ECMO/ECLS has ended. The primary goal is to restore natural blood flow without mechanical assistance.
Indications
- Successful weaning off ECMO/ECLS.
- Stabilization of heart and lung function.
- Physician's assessment indicating no further need for extracorporeal support.
Preparation
- Fasting for a specified period prior to the procedure.
- Evaluation of the child's overall health and readiness to come off ECMO/ECLS.
- Blood tests and imaging studies to assess the patient’s condition.
Procedure Description
- The child is placed under general anesthesia to ensure they are asleep and do not feel pain.
- The physician makes an incision over the site where the cannula(e) are inserted.
- Cannulae are carefully removed from the blood vessels.
- The blood vessels and incision site are then closed and sutured.
- The area is cleaned and dressed to prevent infection.
Duration
Typically takes around 1 to 2 hours.
Setting
Performed in a hospital operating room or a specialized intensive care unit.
Personnel
- Pediatric surgeons
- Anesthesiologists
- Surgical nurses
- ECMO specialists
Risks and Complications
- Infection at the site of cannula removal
- Bleeding or blood clots
- Vascular injury
- Pain or discomfort at the incision site
Benefits
- Allows for the natural function of heart and lungs to resume.
- Reduces the risks associated with prolonged use of ECMO/ECLS.
- Promotes recovery and improves overall prognosis.
Recovery
- Close monitoring in the intensive care unit post-procedure.
- Pain management with appropriate medications.
- Instructions for wound care and potential activity restrictions.
- Follow-up appointments to ensure proper healing and cardiovascular function.
Alternatives
- Continuing ECMO/ECLS if criteria for removal are not met.
- Transition to other forms of mechanical ventilation if necessary.
- Each alternative has its own risks, benefits, and is considered based on individual patient condition.
Patient Experience
- The child will be under anesthesia during the procedure and will not feel pain.
- Post-procedure discomfort or pain at the incision site, managed with pain relief measures.
- Gradual resumption of normal activities as tolerated, under medical guidance.