ECMO circuit chatter - rhythmic pulsations in the drainage catheter/tubing leading to the pump
CHATTER occurs when there is insufficient venous inflow to match the negative pressure generated by the pump, transiently decreasing pump flow. Untreated it can cause the pump to CUT-OUT.
Tx of CHATTER:
 - decrease pump speed (RPM)
 - ensure tubing isn’t kinked
 - confirm cannula positioning & exclude PTX (CXR) 
 - reposition to increase venous return (e.g. Trendelenburg)
 - assess for hypovolemia/bleeding & consider bolus
 - rarely a second venous cannula may be required

Nick Mark MD @nickmmark

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