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urzu_seven t1_iv8syug wrote

Reply to comment by Fluapaveggen in During heart transplanting, how does the body survive before the heart is replaced? by harkhinz

A heart lung bypass machine used during surgery has a recommended usage limit of 6 hours though it can be used up to 10 hours. The limiting factor is the development of blood clots due to the nature of the machine and how it affects blood.

If a longer period is necessary a different, though similar device called an ECMO ( extracorporeal membrane oxygenation) machine can be used. These can be used for multiple days, with an upper limit around 30. However due to the prolonged use of blood thinners and other issues problems such as excessive bleeding can occur so it’s not ideal.

Finally, short of a living heart transplant there is the artificial heart, which has been able to last up to 5 years in some cases.

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auraseer t1_iv9dfvv wrote

30 days is the usual quoted upper limit of ECMO, but that's an estimate. Some patients can survive much longer on it, into the hundreds of days. There's a published report of one patient who was on ECMO for 605 days, and survived to recover.

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rharvey8090 t1_iv9j1ru wrote

I can assure you that I have personally had several patients on ECMO much longer than 30. Don’t think I’ve ever gotten close to 605 though!

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Thedurtysanchez t1_iv9ygep wrote

Our son was at risk of needing ECMO and the main risk we heard at the time was a poor understanding of the temperature fluctuations in the blood supply could lead to cognitive or behavior complications later in life. Have you experienced that at all?

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rharvey8090 t1_iv9zjll wrote

To be totally honest, I have pretty much zero experience with pediatric ECMO usage, just adults. In our adult patients, we have a controlled temp water bath connected to the circuit for temperature maintenance.

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Thedurtysanchez t1_iva09l4 wrote

I believe they do it for the newborns as well, but the variations may have been enough.

He was on bypass for his surgeries and even that lead the surgeons to let us know he is at higher risk for ADHD for some reason they don't fully understand.

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k9moonmoon t1_ivbgz4y wrote

I wonder if there's a physical causation or if it's just, kids that go through something like that are being closely monitored by parents as they grow and so symptoms for ADHD that might otherwise be overlooked get caught more? How common is an increase in ADHD in similarly expansive interventions in other kids? But bodies are so weird, it being a physical impact that will one day be understood exactly how it works, I'd believe.

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EarthyFeet t1_iv9o4at wrote

Oh we heard a lot about ECMO devices being used in the ICUs during covid for some (I'm assuming) critical cases, and it was a limited resource

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Accomplished_River43 t1_ivavgic wrote

Can that machine be made the size of a heart?

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urzu_seven t1_ivax181 wrote

There are artificial hearts that can be implanted and as i mentioned have a life up to 5 years. Those are also the most complicated and expensive for that reason. You don’t need a HLB machine to be implanted because you are only using it temporarily.

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