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Anticoagulation with VADs and ECMO: walking the tightrope

Abstract The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac..

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Unique static discharge events on two CentriMag® (2nd Gen) ECMO patients causing console failure

Abstract The use of ECMO for cardiovascular support continues to increase in the United States and around the world. It is not a benign endeavor as serious complications may occur...

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Addressing the challenges of ECMO simulation

Abstract Introduction/Aim: The patient’s condition and high-risk nature of extracorporeal membrane oxygenation (ECMO) therapy force clinical services to ensure clinicians are properly trained and always ready to deal effectively with..

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Long venous cannula on the arterial position for VA-ECMO

Abstract Differential hypoxia and the arterial mixing zone are two important factors in managing peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO). With the aim of improving perfusion to the aortic arch..

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Late-onset right ventricular dysfunction after mechanical support by a continuous-flow left ventricular assist device

Abstract Background Right heart failure (RHF) is a serious post-operative complication of left ventricular assist device (LVAD) implantation, with significant morbidity and mortality. Many clinical, hemodynamic and laboratory variables have..

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Insight into ECMO, mortality and ARDS: a nationwide analysis of 45,647 ECMO runs

Abstract Background Extracorporeal life support (ECLS) has become an integral part of modern intensive therapy. The choice of support mode depends largely on the indication. Patients with respiratory failure are..

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Neuromonitoring in the neonatal ECMO patient

Abstract Utilization of extraocorporeal membrane oxygenation (ECMO) has become increasingly widespread as a bridging therapy for neonates with severe, reversible respiratory or cardiac diseases. While significant risks remain, due to..

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Switching to Centrifugal Pumps May Decrease Hemolysis Rates Among Pediatric ECMO Patients

Abstract Recent advances in ECLS technology have led to the adoption of centrifugal pumps for the majority of patients worldwide. Despite several advantages of centrifugal pumps, they remain controversial because..

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Membrane Lung and Blood Pump Use During Prolonged Extracorporeal Membrane Oxygenation

Trends From 2002 to 2017 Extracorporeal life support (ECLS) has grown in its application since its first clinical description in the 1970s. The technology has been used to support a..

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Left Ventricular Unloading During Veno-Arterial ECMO: A Simulation Study

Abstract Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is widely used in cardiogenic shock. It provides systemic perfusion, but left ventricular (LV) unloading is suboptimal. Using a closed-loop, real-time computer model..

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Comparison of temporary ventricular assist devices and extracorporeal life support in post-cardiotomy cardiogenic shock

Abstract OBJECTIVES Post-cardiotomy cardiogenic shock (PCCS) results in substantial morbidity and mortality, whereas refractory cases require mechanical circulatory support (MCS). The aim of the study was to compare extracorporeal membrane..

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ECMO use and mortality in adult patients with cardiogenic shock: a retrospective observational study in U.S. hospitals

Abstract Background Extracorporeal membrane oxygenation (ECMO) is increasingly used in resuscitation of critically ill patients with documented improved survival. Few studies describe ECMO use in cardiogenic shock. This study examines..

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Role of ECMO in congenital diaphragmatic hernia

Abstract Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology..

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Prophylactic intra-aortic balloon counterpulsation before surgical myocardial revascularization in patients with acute myocardial infarction

Abstract Introduction: Prophylactic intra-aortic balloon counterpulsation (pIABC) is recommended for high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. Criteria for high-risk patients benefiting from pIABC are unclear. This study..

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Position paper for the organization of ECMO programs for cardiac failure in adults

Abstract Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock,..

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Postcardiotomy VA-ECMO for refractory cardiogenic shock

Abstract Postcardiotomy cardiogenic shock (PCCS) is a rare but catastrophic syndrome that can occur following separation from cardiopulmonary bypass or at any time during the immediate postoperative course. The management..

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Successful use of an automated proning system to achieve prone positioning in a patient with severe ARDS requiring veno-venous ECMO

Abstract A morbidly obese middle aged woman in her 40’s presented to another hospital with methicillin resistant staphylococcus aureus pneumonia and subsequently developed severe acute respiratory distress syndrome. Her oxygenation..

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Veno-arterial-ECMO in the intensive care unit: From technical aspects to clinical practice

The use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) as a salvage therapy in cardiogenic shock is becoming of current practice. While VA-ECMO is potentially a life-saving technique, results are sometimes mitigated, emphasising the need for selecting..

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Advanced mechanical circulatory support for post-cardiotomy cardiogenic shock: a 20-year outcome analysis in a non-transplant unit

Background Post-cardiotomy cardiogenic shock (PCCS) has an incidence of 2–6 % after routine adult cardiac surgery. 0.5–1.5 % are refractory to inotropic and intra-aortic balloon pump (IABP) support. Advanced mechanical circulatory support..

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International survey on the management of mechanical ventilation during ECMO in adults with severe respiratory failure

BACKGROUND: No consensus exists on the optimal settings of mechanical ventilation during veno-venous extracorporeal membrane oxygenation (ECMO). Our aim was to describe how mechanical ventilation and related interventions are managed..

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“Awake” extracorporeal membrane oxygenation (ECMO): pathophysiology, technical considerations, and clinical pioneering

Venovenous extracorporeal membrane oxygenation (vv-ECMO) has been classically employed as a rescue therapy for patients with respiratory failure not treatable with conventional mechanical ventilation alone. In recent years, however, the..

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Setting mechanical ventilation in ARDS patients during VV-ECMO: where are we?

Currently, many centers use venovenous extracorporeal membrane oxygenation (VV-ECMO) as an adjunctive means of gas exchange to mechanical ventilation (MV) in patients with severe ARDS and refractory hypoxemia. One of..

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Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO)

Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective..

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COVID-19 and ECMO: An Unhappy Marriage of Endothelial Dysfunction and Hemostatic Derangements

Severe respiratory syndrome coronavirus-2 is responsible for coronavirus disease 2019 (COVID-19), which may lead to acute respiratory failure. In its most severe manifestation including refractory hypoxemia and/or hypercapnia, it can..

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Inter-hospital COVID ECMO Air Transportation

The Coronavirus Disease 2019 (COVID-19) pandemic has required rapid and effective protocol adjustments at every level of healthcare. The use of extracorporeal membrane oxygenation (ECMO) is pivotal to COVID-19 treatment..

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Successful Use of An Automated Proning System to Achieve Prone Positioning in A Patient with Severe ARDS Requiring Veno-Venous ECMO

Abstract A morbidly obese middle aged woman in her 40's presented to another hospital with  and subsequently developed severe . Her oxygenation demonstrated no improvement with low  ventilation, paralysis, or prostagladin therapy. She..

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Pediatric Intensive Care Preparedness and ECMO Availability in Children With COVID-19: An International Survey

Abstract Since the beginning of the pandemic Coronavirus Disease 2019 (COVID-19), calls were made for informed allocation of costly, limited health care resources such as extracorporeal membrane oxygenation (ECMO). At..

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Extracorporeal Life Support for Cardiogenic Shock with Either A Percutaneous Ventricular Assist Device or An Intra-Aortic Balloon Pump

Abstract Extracorporeal life support (ECLS) can result in complications due to increased left ventricular (LV) afterload. The percutaneous ventricular assist device (PVAD) and intra-aortic balloon pump (IABP) are both considered..

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Evaluation of Recirculation During Venovenous Extracorporeal Membrane Oxygenation Using Computational Fluid Dynamics Incorporating Fluid-Structure Interaction

Abstract Recirculation in venovenous extracorporeal membrane oxygenation (VV ECMO) leads to reduction in gas transfer efficiency. Studies of the factors contributing have been performed using in vivo studies and computational..

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Practical Management of ECPELLA

Abstract Veno-arterial extracorporeal membrane oxygenation (ECMO) is a strong mechanical circulatory device for patients with hemodynamic deterioration due to cardiogenic shock, but its drawback is an increase in left ventricular..

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