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The importance of the development of extracorporeal life support simulation centres for improving skills and knowledge during the COVID-19 pandemic

Abstract Introduction Extracorporeal techniques have been present in medicine for over 70 years. Many factors in history have influenced their development and popularisation, in particular the first discoveries of heparin..

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Developing a generalizable pediatric ECMO emergency checklist for clinical specialist: Progress and challenges

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) emergencies require skilled clinical specialist (CS) who manage ECMO circuits. While tools for assessing CS skills have been published, there is significant variation in..

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Carboxyhemoglobin predicts oxygenator performance and imminent oxygenator change in extracorporeal membrane oxygenation

Abstract Background The continuous exposure of blood to a non-biological surface during extracorporeal membrane oxygenation (ECMO) may lead to progressive thrombus formation in the oxygenator, hemolysis and consequently impaired gas..

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The effect of excessive gas to blood ratios in an ECMO oxygenator

Abstract Introduction Oxygenators for paediatric Extracorporeal Membrane Oxygenation (ECMO) are required to operate over a wide range of flow rates, in a patient group ranging from neonates through to fully..

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Psychological safety in an ECMO retrieval team: a qualitative study to inform improvement

Abstract Introduction In healthcare teams, psychological safety is associated with improved performance, communication, collaboration and patient safety. Extracorporeal membrane oxygenation (ECMO) retrieval teams are multidisciplinary teams that initiate ECMO therapy for..

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Clinical Practice of Pre-Assembling and Storing of Extracorporeal Membrane Oxygenation Systems

Abstract According to the Extracorporeal Life Support Organization (ELSO) guidelines, pre-assembled and already primed extracorporeal membrane oxygenation (ECMO) systems can be safely stored for up to 30 days under specific..

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Right Ventricular Assist Device Placement During Left Ventricular Assist Device Implantation Is Associated With Improved Survival

Abstract Right ventricular failure (RVF) is a significant cause of mortality in patients undergoing left ventricular assist device (LVAD) implantation. Although right ventricular assist devices (RVADs) can treat RVF in..

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Complications during Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 and Non-COVID-19 Patients with Acute Respiratory Distress Syndrome

Abstract Background: Acute respiratory distress syndrome (ARDS) presents a significant challenge in critical care settings, characterized by compromised gas exchange, necessitating in the most severe cases interventions such as veno-venous extracorporeal..

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Carbon Dioxide Targets in Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome

Abstract Target values for arterial carbon dioxide tension (PaCO2) in extracorporeal membrane oxygenation (ECMO) for acute respiratory distress syndrome (ARDS) are unknown. We hypothesized that lower PaCO2 values on ECMO would..

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Validation of predictive models for 90-day survival in immunocompromised patients with cardiogenic shock on venoarterial extracorporeal membrane oxygenation

Abstract Predictive survival models have been proposed to esti-mate survival rates in patients with refractory cardio-genic shock considered for veno-arterial extracorporeal membrane oxygenation (VA-ECMO) [1, 2]. Notably, the Survival after..

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Why left atrial venting fails to influence extracorporeal life support survival in cardiogenic shock: Unravelling the intricate reality of unloading

Abstract Over the past decade, extracorporeal life support (ECLS) has gained increasing utilization in the management of refractory cardiogenic shock (CS) with a class IIaC recommendation according to the latest..

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Prone Positioning and Right Ventricular Protection During Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome

Abstract In critically ill patients with moderate to severe acute respiratory distress syndrome (ARDS) receiving invasive mechanical ventilation, prone positioning for 16 hours/day has been shown to confer significant mortality..

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Immunofluorescence Protocol for Characterization of Platelet and Leukocyte Binding in Extracorporeal Membrane Oxygenation (ECMO) Circuits

Abstract The continuous contact between blood and the foreign surface of the extracorporeal membrane oxygenation (ECMO) circuit contributes to hemostatic, inflammatory, and other physiological disturbances observed during ECMO. Although previous..

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Acquired von Willebrand syndrome during extracorporeal membrane oxygenation support: a comprehensive review of current evidence: Communication from the ISTH SSC…

Abstract During extracorporeal membrane oxygenation (ECMO) support, the high shear stress in the ECMO circuit results in increased proteolysis of von Willebrand Factor (VWF), loss of VWF high molecular weight..

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Management of Left Ventricular Intramural Hematoma- an Unusual Complication of Complete Atrioventricular Septal Defect Repair in a Child

Abstract Postoperative survival for complete atrioventricular septal defect (cAVSD) is excellent. Common complications of surgery include valvular stenosis/regurgitation, left ventricular outflow tract obstruction, arrythmias, and residual defects. We report a..

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Routine venoarterial extracorporeal membrane oxygenation for acute myocardial infarction‑related cardiogenic shock: what we know and don’t know

Abstract Acute myocardial infarction-related cardiogenic shock (AMI-CS) carries a dismal prognosis. Short-term mortality is in the range of 40–50% [1]. Until recently, only treatment of the culprit lesion by percutaneous..

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Sterility and oxygenator function in pre-primed extracorporeal membrane oxygenation: A prospective clinical study

Abstract Aim Minimizing cardiac arrest times is critical in extracorporeal cardiopulmonary resuscitation (ECPR). Pre-primed extra corporeal membrane oxygenator (ECMO) is used for this, but knowledge is limited to experimental studies...

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The Jena Method: Perfusionist Independent, Standby Wet-Primed Extracorporeal Membrane Oxygenation (ECMO) Circuit for Immediate Catheterization Laboratory and/or Hybrid Operating Room…

Abstract Background: The timely initiation of extracorporeal membrane oxygenation (ECMO) is crucial for providing life support. However, delays can occur when perfusionists are not readily available. The Jena Method aims to..

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Interpretation of coagulation laboratory tests for patients on ECMO

Abstract Extracorporeal membrane oxygenation (ECMO) is a type of circulatory life support for patients with severe lung failure. The use of ECMO has increased worldwide since the pandemic of H1N1..

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Comparison of Weaning Strategies in Patients Receiving Venovenous Extracorporeal Membrane Oxygenation: An Exploratory Retrospective Study

Abstract Venovenous extracorporeal membrane oxygenation (VV ECMO) facilitates the reduction of mechanical ventilation (MV) support in acute respiratory failure. Contrary to increasing evidence regarding its initiation, the optimal timing of..

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Technique for Weaning From Peripheral Venopulmonary Extracorporeal Membrane Oxygenation in Combined Cardiopulmonary Failure

Abstract Venopulmonary (VP) extracorporeal membrane oxygenation (ECMO) is a mode capable of supporting both pulmonary and right ventricular (RV) functions. Weaning patients from VP ECMO requires careful assessment of both..

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Platelet Adhesion and Activation in an ECMO Thrombosis-on-a-Chip Model

Abstract Use of extracorporeal membrane oxygenation (ECMO) for cardiorespiratory failure remains complicated by blood clot formation (thrombosis), triggered by biomaterial surfaces and flow conditions. Thrombosis may result in ECMO circuit..

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Central Venopulmonary Extracorporeal Membrane Oxygenation: Background and Standardized Nomenclature

Abstract This review highlights advancements in extracorporeal life support (ECLS), emphasizing the critical role of standardized terminology, particularly for extracorporeal membrane oxygenation (ECMO) in treating right ventricular and respiratory failure...

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HAPTOGLOBIN DEPLETION DURING THE FIRST 7 DAYS OF VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION THERAPY IS ASSOCIATED WITH INCREASED MORTALITY AND ADVERSE…

Abstract Background: Hemolysis is a frequent complication in patients with sepsis, ARDS, or extracorporeal membrane oxygenation (ECMO). Haptoglobin (Hp) can scavenge released cell-free hemoglobin (CFH). Hemolysis and low plasma concentrations of..

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Beyond one-size-fits-all in cardiogenic shock: impella, extracorporeal membrane oxygenation or tailored use of mechanical circulatory support?

Abstract Purpose of review  This article offers an overview of recent randomized controlled trials (RCTs) testing the efficacy of veno-arterial extracorporeal membrane oxygenation (VA ECMO) and microaxial flow pump (mAFP)..

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Consumptive coagulopathy: how low-dose unfractionated heparin can prevent bleeding complications during extracorporeal life support

Abstract Bleeding and thrombotic complications are major drivers in extracorporeal life support (ECLS) patients’ negative outcomes and are reported in up to 40% of the ECLS-runs [1, 2]. Consumptive coagulopathy..

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Beyond Venoarterial and Venovenous Extracorporeal Membrane Oxygenation: Novel Cannulation Strategies

Introduction Extracorporeal membrane oxygenation (ECMO) is a means of supporting the heart, lungs, or both when more conventional therapy fails to achieve appropriate physiologic endpoints.   The majority of ECMO..

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New Right Ventricular Dysfunction in Pediatric Acute Respiratory Distress Syndrome on Venovenous Extracorporeal Membrane Oxygenation

Abstract The development of new right ventricular (RV) dysfunction after cannulation to venovenous (VV) extracorporeal membrane oxygenation (ECMO) and its association with worse outcomes is increasingly recognized in adult patients,..

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Mechanical circulatory support in cardiogenic shock: microaxial flow pumps for all and VA‑ECMO consigned to the museum?

Abstract Introduction Mortality rates in cardiogenic shock remain high, especially in patients with SCAI shock stages C to E [1].When hemodynamic status does not improve or worsens despite optimal fluid,..

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Kelli's Story: Mobile ECMO

Kelli Shaw, 34, believes in happy endings. On June 9, 2024, the Bedford, New Hampshire mother of three celebrated her 10-year wedding anniversary with a vow renewal ceremony. It is..

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