Extracorporeal
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Extracorporeal
An extracorporeal is a medical procedure which is performed outside the body. Extracorporeal devices are the artificial organs that remain outside the body while treating a patient. Extracorporeal devices are useful in hemodialysis and cardiac surgery. Circulatory procedures A procedure in which blood is taken from a patient's circulation to have a process applied to it before it is returned to the circulation. All of the apparatus carrying the blood outside the body is termed the extracorporeal circuit. * Apheresis * Autotransfusion * Hemodialysis * Hemofiltration * Plasmapheresis * Extracorporeal carbon dioxide removal * Extracorporeal cardiopulmonary resuscitation * Extracorporeal membrane oxygenation (ECMO) * Cardiopulmonary bypass during open heart surgery. Other procedures Extracorporeal shockwave lithotripsy (ESWL), which is unrelated to other extracorporeal therapies, in that the device used to break up the kidney stones is held completely outside the body, whilst the lith ...
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Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life. The technology for ECMO is largely derived from cardiopulmonary bypass, which provides shorter-term support with arrested native circulation. The device used is a membrane oxygenator, also known as an artificial lung. ECMO works by temporarily drawing blood from the body to allow artificial oxygenation of the red blood cells and removal of carbon dioxide. Generally, it is used either post-cardiopulmonary bypass or in late-stage treatment of a person with profound heart and/or lung failure, although it is now seeing use as a treatment for cardiac arrest in certain centers, allowing treatment of the underlying cause of arrest while circulation and oxygenation are supported. ECMO is als ...
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Extracorporeal Cardiopulmonary Resuscitation
Extracorporeal cardiopulmonary resuscitation (commonly known as ECPR) is a method of cardiopulmonary resuscitation (CPR) that passes the patient's blood through a machine in a process to oxygenate the blood supply. A portable extracorporeal membrane oxygenation (ECMO) device is used as an adjunct to standard CPR. A patient who is deemed to be in cardiac arrest refractory to CPR has percutaneous catheters inserted into the femoral vein and artery. Theoretically, the application of ECPR allows for the return of cerebral perfusion in a more sustainable manner than with external compressions alone. By attaching an ECMO device to a person who has acutely undergone cardiovascular collapse, practitioners can maintain end-organ perfusion whilst assessing the potential reversal of causal pathology, with the goal of improving long-term survival and neurological outcomes. Concept Similar to the concept of elective cardiopulmonary bypass, used in open heart surgery, oxygenation and perfu ...
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Extracorporeal Shockwave Lithotripsy
Extracorporeal shockwave therapy (ESWT) is a non-invasive, out-patient alternative to surgery for those with many joint and tendon disorders. ESWT sends acoustic shock waves into bone or soft tissue, in effect reinjuring the area on a cellular level and breaking up the scarring that has penetrated tendons and ligaments. The controlled reinjuring of tissue allows the body to regenerate blood vessels and bone cells. The resulting revascularization leads to faster healing and often a return to pre-injury activity levels. It is a treatment using powerful acoustic pulses which is mostly used to treat kidney stones and in physical therapy and orthopedics. Medical uses The most common use of extracorporeal shockwave therapy (ESWT) is for lithotripsy to treat kidney stones (urinary calculosis) and biliary calculi (stones in the gallbladder or in the liver) using an acoustic pulse. It is also reported to be used for salivary stones and pancreatic stones. In the UK, the National Institu ...
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Cardiopulmonary Bypass
Cardiopulmonary bypass (CPB) is a technique in which a machine temporarily takes over the function of the heart and lungs during surgery, maintaining the circulation of blood and oxygen to the body. The CPB pump itself is often referred to as a heart–lung machine or "the pump". Cardiopulmonary bypass pumps are operated by perfusionists. CPB is a form of extracorporeal circulation. Extracorporeal membrane oxygenation is generally used for longer-term treatment. CPB mechanically circulates and oxygenates blood for the body while bypassing the heart and lungs. It uses a heart–lung machine to maintain perfusion to other body organs and tissues while the surgeon works in a bloodless surgical field. The surgeon places a cannula in the right atrium, vena cava, or femoral vein to withdraw blood from the body. Venous blood is removed from the body by the cannula and then filtered, cooled or warmed, and oxygenated before it is returned to the body by a mechanical pump. The cannula used ...
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Hemodialysis
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure. Hemodialysis is one of three renal replacement therapies (the other two being kidney transplant and peritoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma or cells is apheresis. Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility, either a purpose-built room in a hospital or a dedicated, stand-alone clinic. Less frequently hemodialysis is done at home. Dialysis treatments in a clinic are initiated and managed by specialized staff made up of nurses and technicians; dialysis treatments at home can be self-initiated and managed ...
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Apheresis
Apheresis ( ἀφαίρεσις (''aphairesis'', "a taking away")) is a medical technology in which the blood of a person is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation. It is thus an extracorporeal therapy. One of the uses of apheresis is for collecting stem cells. Method Depending on the substance that is being removed, different processes are employed in apheresis. If separation by density is required, centrifugation is the most common method. Other methods involve absorption onto beads coated with an absorbent material and filtration. The centrifugation method can be divided into two basic categories: Continuous flow centrifugation Continuous flow centrifugation (CFC) historically required two venipunctures as the "continuous" means the blood is collected, spun, and returned simultaneously. Newer systems can use a single venipuncture. The main advantage of this system is the low extraco ...
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Hemodialysis
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure. Hemodialysis is one of three renal replacement therapies (the other two being kidney transplant and peritoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma or cells is apheresis. Hemodialysis can be an outpatient or inpatient therapy. Routine hemodialysis is conducted in a dialysis outpatient facility, either a purpose-built room in a hospital or a dedicated, stand-alone clinic. Less frequently hemodialysis is done at home. Dialysis treatments in a clinic are initiated and managed by specialized staff made up of nurses and technicians; dialysis treatments at home can be self-initiated and managed ...
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Intracorporeal (other)
Intracorporeal or intracorporal is an adjective that means within ''(intra-)'' the body ''(corpus)''. Its antonym is extracorporeal. It is used frequently in medicine to describe medical procedures that occur within the body, or within a corpus, as opposed to extracorporeal procedures (e.g. extracorporeal membrane oxygenation). In a medical or surgical context, it may refer to: * Intracorporeal anastomosis * Intracorporeal circulation * Intracorporeal energy harvesting, harvesting energy from the body, and storing it, to sustain a medical device (e.g. a pacemaker). * Intracorporeal injection * Intracorporeal microrobotics * Intracorporeal reconstruction * Intracorporeal suturing * Intracorporeal urinary diversion * Lithotripsy: ** Intracorporeal electrohydraulic lithotripsy ** Intracorporeal laser lithotripsy ** Intracorporeal pneumatic lithotripsy ** Intracorporeal shock wave lithotripsy See also * * * Human body (''corpus humanum'') * ''In vivo Studies that ...
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Autotransfusion
Autotransfusion is a process wherein a person receives their own blood for a transfusion, instead of banked allogenic (separate-donor) blood. There are two main kinds of autotransfusion: Blood can be autologously "pre-donated" (termed so despite "donation" not typically referring to giving to one's self) before a surgery, or alternatively, it can be collected during and after the surgery using an intraoperative blood salvage device (such as a Cell Saver, HemoClear or CATS). The latter form of autotransfusion is utilized in surgeries where there is expected a large volume blood loss – e.g. aneurysm, total joint replacement, and spinal surgeries. The effectiveness, safety, and cost-savings of intraoperative cell salvage in people who are undergoing thoracic or abdominal surgery following trauma is not known. The first documented use of "self-donated" blood was in 1818, and interest in the practice continued until the Second World War, at which point blood supply became less of an ...
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Cardiac Surgery
Cardiac surgery, or cardiovascular surgery, is surgery on the heart or great vessels performed by cardiac surgeons. It is often used to treat complications of ischemic heart disease (for example, with coronary artery bypass grafting); to correct congenital heart disease; or to treat valvular heart disease from various causes, including endocarditis, Rheumatic fever, rheumatic heart disease, and atherosclerosis. It also includes heart transplantation. History 19th century The earliest operations on the pericardium (the sac that surrounds the heart) took place in the 19th century and were performed by Francisco Romero (surgeon), Francisco Romero (1801) in the city of Almería (Spain), Dominique Jean Larrey (1810), Henry Dalton (1891), and Daniel Hale Williams (1893). The first surgery on the heart itself was performed by Axel Cappelen on 4 September 1895 at Rikshospitalet in Kristiania, now Oslo. Cappelen ligature (medicine), ligated a bleeding coronary circulation, coronary ...
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Hemofiltration
Hemofiltration, also haemofiltration, is a renal replacement therapy which is used in the intensive care setting. It is usually used to treat acute kidney injury (AKI), but may be of benefit in multiple organ dysfunction syndrome or sepsis. During hemofiltration, a patient's blood is passed through a set of tubing (a ''filtration circuit'') via a machine to a semipermeable membrane (the ''filter'') where waste products and water (collectively called ''ultrafiltrate'') are removed by convection. Replacement fluid is added and the blood is returned to the patient. As in dialysis, in hemofiltration one achieves movement of solutes across a semi-permeable membrane. However, solute movement with hemofiltration is governed by convection rather than by diffusion. With hemofiltration, dialysate is not used. Instead, a positive hydrostatic pressure drives water and solutes across the filter membrane from the blood compartment to the filtrate compartment, from which it is drained. Solutes, ...
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Plasmapheresis
Plasmapheresis (from the Greek πλάσμα, ''plasma'', something molded, and ἀφαίρεσις ''aphairesis'', taking away) is the removal, treatment, and return or exchange of blood plasma or components thereof from and to the blood circulation. It is thus an extracorporeal therapy, a medical procedure performed outside the body. Three general types of plasmapheresis can be distinguished: * ''Autologuous'', removing blood plasma, treating it in some way, and returning it to the same person, as a therapy. * ''Exchange'', a patient's blood plasma is removed, while blood products are given in replacement. This type is called plasma exchange (PE, PLEX, or PEX) or plasma exchange therapy (PET). The removed plasma is discarded and the patient receives replacement donor plasma, albumin, or a combination of albumin and saline (usually 70% albumin and 30% saline). * ''Donation'', removing blood plasma, separating its components, and returning some of them to the same person, while ho ...
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