🚨 Attention, critical care transport professionals!
FlightBridgeED’s Circulating Hope: Managing ECMO Patients in Transport—the first & only course of its kind—is in final edits. Led by Dr. Lauria, Dr. Bernardoni, & Hoffman, with Verkest filming at UW MedFlight today. ECMO’s surging; we lead with serious, practical training. Elevate skills & save lives. Stay tuned—launching soon!
🔗 flightbridgeed.com
#flightbridgeed #ECMO #MichaelLauria #BrittneyBernardoni #BruceHoffman
In-hospital #outcomes and 6-month follow-up results of #patients supported with #ECMO for #COVID19 from the 2nd wave to end of pandemic (EuroECMO-COVID)..., https://etidiohnew.blogspot.com/2025/02/in-hospital-outcomes-and-6-month-follow.html
New infographic by
Dr. Em Gootee
“Optimizing #CDH Repair on #ECMO: Evaluating the Risk of #Bleeding“ Schmoke N et. al.
Full text: https://gcmd.pulse.ly/gtrzzlvkik
#pedsurg #SoMe4PedSurg #surgery #hernia #congenital #jpedsurg #meded
Made possible by
@CincyChildrens
Microbubbles Deliver Lifesaving Oxygen: lipid-coated polymer oxygen microbubbles, injected directly into the bloodstream, rapidly dissolve and release oxygen that can be safely absorbed by red cells. #oxygen #lipidcoat #microbubbles #ecmo
https://www.instagram.com/drhowardsmithreports/reel/DE3BTQTtVlh/
In this study, Chang et al. investigated the feasibility of using #NIRS for the prediction of critical conditions in patients receiving Extracorporeal Membrane Oxygenation.
The PortaLite was used to measure oxygenation on the calf and machine learning was applied to differentiate disease severity in two #ECMO modes (veno-venous and veno-arterial), and NIRS proved potential in estimating improvements in patient condition.
Target values for arterial CO2 in #ECMO support for #ARDS? Lower PaCO2 associated with lighter sedation:
🔍 2 independent cohorts, discovery & validation
💨 median PaCO2 41 mm Hg in both
💨 lower PaCO2 & higher pH but not HCO3 significant predictors for RASS -2 to +1 (= lightly sedated to restless); after multivariable adjustment only PaCO2 remained associated with target RASS
💨 PaCO2 ≤40 mm Hg associated with increased probability of sedation within target range in both
🖇️ https://bit.ly/45NH0vg
Routine prophylactic vs selective distal perfusion catheter to decrease limb ischemia in VA #ECMO
🖥️ patients followed daily by vascular surgery with continuous rSO2 monitoring
🪦30 day mortality highest in patients with upfront DPC
With strict adherence to a monitoring protocol for limb ischemia, selective strategy safe, not compromizing excellent clinical outcomes, & may obviate the risks of additional arterial catheter.
🖇️ https://bit.ly/3xIICtB
Investigating/characterizing platelet & leukocyte adsorption in #ECMO circuits
💡detailed protocol utilizing immunofluorescence to help extend knowledge in binding mechanisms + pathophysiology of adsorption, providing guidance for better circuit design. Protocol enabling comprehensive characterization of cellular binding to circuits collected from patients, could also be adapted to circuit binding studies of other #ECLS systems, such as #CPB, #VAD, #RRT devices.
🖇️ https://bit.ly/3XK4oYD
Prone positioning in patients with #ARDS on #ECMO support... Proning may unload & protect the RV through
🫁 homogenous lung aeration & reduced pulmonary capillary/extra-alveolar vessel compression with decreased ventral-dorsal transpulmonary pressure difference
🫁 mitigation of VILI through recruitment of collapsed alveoli in dorsal lung regions
🩸increase in thoracic circulation blood volume may recruit pulmonary microvasculature
ASAIO Journal
🖇️ https://bit.ly/4btYttI
Acquired von Willebrand syndrome in #ECMO support, review of current evidence
🔍 prevalence of AVWS in #ECLS children & adults
🩸 bleeding complications in AVWS
⚙️ management
💉 desmopressin & VWF-containing concentrates.
🛑 inhibition of ADAMTS-13-mediated proteolysis of VWF
Limited evidence & need for a consensus definition, but data suggest almost all pts develop partial/complete loss of VWF HMW multimers within hours since initiation; weaning completely resolves AVWS.
🖇️ https://bit.ly/3RK3OGp
Thrombolysis before VA #ECMO cannulation in high-risk pulmonary embolism
🔍 72 high-risk PE pts; 43% underwent pre-ECMO thrombolysis
🩸incidence of moderate-to-severe bleeding notably elevated in both groups
🪦 no difference in 90-day survival if systemic thrombolysis or not
🗓️ long-term QoL acceptable; no chronic thromboembolic pulmonary hypertension
Recent systemic thrombolysis, as a single parameter, should not be considered contraindication for #ECLS in this population
🔓 https://rdcu.be/dLOBk
📢 The June 2024 ELSO newsletter is out! DoN'T miss:
🖋️ Message from our President, Graeme MacLaren
🛏 Bedside with Dr Bartlett: why we have gas blender in the sweep gas?? Answer is different for VV & VA #ECMO
🎓 ELSO Academy: the Neonatal & Pediatric Foundations training course
🌏 #ECLS around the world, updates from ELSO Chapters including next annual meetings & conferences
📃 News from ELSO Committees
🖋️ CEO Christine Stead remarks & more! Read all on ELSO website at
🔗 bit.ly/2IR8RCl
Mechanical circulatory support in cardiogenic shock:
🏛️ VA #ECMO to be consigned to the museum? NO: systematic use of #ECLS in AMICS not supported, but is useful as optimal therapies fail
🔍 available evidence & need for: real benefit of ECMO difficult to show in RCTs, especially as will likely continue to be used as rescue strategy
🪡 personalize management! Both VA-ECMO & MFP have a role in severe CS: select most appropriate #MCS for the specific patient
🔓 https://rdcu.be/dLt6T
Consumptive coagulopathy during #ECLS
🔎 close monitoring & follow up pivotal during the #ECMO run
⛔️ giving platelets/clotting factors to fix numbers often worsens underlying process
🩸 low doses of anticoagulants may protect both circuit (vs thrombotic complications) & patient (vs bleeding & thrombosis)
⛔️ bleeding complications should NOT always prompt complete cessation of UFH
Detailed underlying pathophysiological process & physiological rationale free to read #FOAMcc
🔓 https://rdcu.be/dLmXO
Beyond VA & VV #ECMO, novel, alternative cannulation strategies to address unique factors related to individual cases when traditional configuration are not enough...
🫁 parallel VV circuits: to provide higher EBF/CO2 clearance in patients with ARDS with high CO & VO2
🫁🫀veno-venopulmonary #ECLS: added benefit of RV support
🫀 LAVA ECMO: biventricular support with biatrial unloading
🫀 LV apical insertion of dual-lumen cannula if significant peripheral vascular disease
🖇️ https://bit.ly/3zk1O0Y
The infection definitions for #MCS... appropriate for #ECMO?? Be cautious:
🍄 most common fungi that cause BSIs are Candida species; if no risk of disseminated infections only obtain conventional blood culture
🩸 blood cultures generally positive from circuit/periphery: avoid accessing circuit. Culturing cannula tip impractical: consider device-related all primary BSI
🧫 circuit/cannula colonization well-described, implications unclear
🖇️ https://bit.ly/3RtWv5B
🧫 Refers to
🔓 https://bit.ly/3y1UvdS
Neue Studie im #JTH von @uniklinikum_Wue zeigt, dass #ECMO bei #ARDS zu Veränderungen in #Thrombozyten führt. Der #GPV-Rezeptor auf den #Blutplättchen wurde als mögliches Ziel zur Vermeidung von Blutungen identifiziert.
https://nachrichten.idw-online.de/2024/06/18/veraenderte-thrombozyten-unter-ecmo-erhoehen-sterberisiko-neue-ansaetze-zur-blutungspraevention
📢 Unmissable opportunity if you want to learn everything about VV (dual site + bicaval-dual lumen) & VA #ECLS cannulation 📢
Some (few) spots still available for ELSO #ECMO Cannulation Workshop on June 23!
A hands-on event aimed to learn how to safely perform percutaneous cannulation with a team of international experts... Register NOW ‼️
🔗 https://bit.ly/3sUQcPq
🎓 Adult #cannulation workshop
🗺️ ELSO Headquarters, Ann Arbor MI
🗓️ June 23 2024 (1 one day session)
📫 ecmotraining@elso.org
🔍 For #ECPR as for all patients keep on caring & keep on analyzing! Initial lactate can indicate higher burden of ischemia prior to #ECMO, with subsequent clearance determined by relationship between lactate catabolism vs generation. Neurologic survival advantage if adequate #extracorporeal BF/catabolic function & no longer ischemia. Pts who fail to rapidly clear lactate warrant evaluation for: ongoing ischemia or insufficient #ECLS
🖇️ https://bit.ly/3KGs2xo
Refers to
🔓 https://bit.ly/3x997bt
Beyond one-size-fits-all in cardiogenic shock: microaxial flow pump, VA #ECMO or tailored use of mechanical circulatory support? Overview of recent evidence
🫀 VA ECMO in AMI should be reserved for extreme CS
🫀 mAFP appears promising for CS due to STEMI & should be preferred MCS
🪜 initial mAFP use in CS with LV failure + #ECLS in refractory cases or if severe RV failure may be promising
⚠️ high complication rates associated with #MCS underscores need for personalized use
🖇️ https://bit.ly/4ekPmyd
