DATE OF SERVICEPERFUSIONISTFACILITYEdit EntryDelete EntrySURGEONPROCEDURESTATUSHOURS ON ECMOMR #Anesthesia Volume Pre-Bypass (mLs)Net Prime Volume (NPV) (mLs)Ultrafiltration on CPB (mLs)Modified Ultrafiltration (MUF) (mLs) - Post BypassPost Induction Hematocrit (%)First CPB Hematocrit (%)Percent Decrease in Hematocrit (%)Lowest CPB Hematocrit (%)Last CPB Hematocrit (%)Last in Room Hematocrit (%)Lowest ACT on CPB (seconds)Lowest Arterial Pressure on CPB (mmHg)Lowest SvO2 on CPB (%)Lowest CPB Base Excess/Deficit (mEq/L)Highest Blood Glucose Level (mg/dL)Highest Arterial Blood Temperature (degrees C)Lowest Core Body Temperature (degrees C)Cytotoxic Drug Type & DosePrime Type and Amount (mLs)Average Inflow Temperature (degrees C)Average Outflow Temperature (degrees C)Pump Flow RateAverage Reservoir Volume (mLs)Additional CommentsAny Transfusion RequiredPacked Red Blood Cells Transfused (mL)Total Fresh Frozen Plasma (units)Total Cryoprecipitate (units)Total Platelet (units)Autologous Blood Transfused within 6 HoursWashed RBCs ReinfusedAnticoagulation Volume Used (mLs)Wash Volume Used (mLs)Estimated Blood Loss (EBL)Clear Effluent Wash LineDownload Quality Report
DATE OF SERVICEPERFUSIONISTFACILITYEdit EntryDelete EntrySURGEONPROCEDURESTATUSHOURS ON ECMOMR #Anesthesia Volume Pre-Bypass (mLs)Net Prime Volume (NPV) (mLs)Ultrafiltration on CPB (mLs)Modified Ultrafiltration (MUF) (mLs) - Post BypassPost Induction Hematocrit (%)First CPB Hematocrit (%)Percent Decrease in Hematocrit (%)Lowest CPB Hematocrit (%)Last CPB Hematocrit (%)Last in Room Hematocrit (%)Lowest ACT on CPB (seconds)Lowest Arterial Pressure on CPB (mmHg)Lowest SvO2 on CPB (%)Lowest CPB Base Excess/Deficit (mEq/L)Highest Blood Glucose Level (mg/dL)Highest Arterial Blood Temperature (degrees C)Lowest Core Body Temperature (degrees C)Cytotoxic Drug Type & DosePrime Type and Amount (mLs)Average Inflow Temperature (degrees C)Average Outflow Temperature (degrees C)Pump Flow RateAverage Reservoir Volume (mLs)Additional CommentsAny Transfusion RequiredPacked Red Blood Cells Transfused (mL)Total Fresh Frozen Plasma (units)Total Cryoprecipitate (units)Total Platelet (units)Autologous Blood Transfused within 6 HoursWashed RBCs ReinfusedAnticoagulation Volume Used (mLs)Wash Volume Used (mLs)Estimated Blood Loss (EBL)Clear Effluent Wash LineDownload Quality Report