Podcasts about ECLS

Following the discussion on ECLS in AMI and cardiogenic shock, we go on to discuss eCPR for cardiac arrest specifically. This episode was recorded live at the Critical Care Canada Forum 2024 as part of our special series on cardiac intensive care. Our guest is Dr. Darryl Abrams, Associate Medical Director and Director of Research for the Medical ECMO Program at New York-Presbyterian/Columbia University. Dr. Abrams joins us for an in-depth discussion on the current state and future direction of extracorporeal cardiopulmonary resuscitation, or eCPR.We dive into the complex world of eCPR in refractory cardiac arrest, starting with a breakdown of the three landmark trials that have shaped the field: the ARREST trial, the Prague OHCA trial, and the INCEPTION trial. Each study offers a unique perspective, from the dramatic early findings of ARREST to the pragmatic design of Prague OHCA and the sobering multicenter outcomes of INCEPTION. A major theme throughout the episode is the role of system design. Dr. Abrams emphasizes the importance of minimizing low-flow time, rapid cannulation, and consistent team expertise—factors that can make or break the success of eCPR. We also explore the ethical and practical considerations that come with rolling out such a resource-intensive intervention, including the balance between innovation and equity. Is it fair that access to eCPR may depend on geography or institutional resources? And how do we make meaningful improvements in survival when only a few centers can offer this advanced care?The episode closes with a practical lens: how should clinicians approach building an ECMO program? What are the essential pieces that need to be in place before considering eCPR? And how do you select patients in a way that balances risk, benefit, and system capacity?Chapters:Introduction and guest welcomeSetting the scene: What is eCPR and why now?The ARREST trial: Small study, big impactThe Prague OHCA trial: Early randomization, broader populationThe INCEPTION trial: Multicenter reality and negative resultsComparing the evidence: Why do outcomes differ?Low-flow time and speed of cannulationThe role of meta-analyses and what they do (and don't) tell usOpportunity cost: What are we giving up to fund eCPR?Duration of support: How long is too long?Will there be another trial? Challenges of equipoiseBuilding a responsible eCPR programPatient selection: Who qualifies and why?Cannulation techniques and adjunct devicesSystem design: U.S. vs. Canada vs. U.K.Ethical concerns and access inequitiesGuidelines and final takeaways

In this episode, recorded live at the Critical Care Canada Forum in Toronto, we dive into extracorporeal life support (ECLS) in cardiogenic shock, with Dr Sean van Diepen. He is an Associate Professor at the University of Alberta, Co-Director of the CCU at the Mazankowski Alberta Heart Institute, and a leading voice in cardiac critical care. Join us as we explore the evolving landscape of mechanical circulatory support, the latest evidence from the DANGER and ECLS-SHOCK trials, and the complexities of patient selection. Key Topics Covered:1. The Evolution of ECLS in Cardiogenic Shock • The 25-year gap since the last positive cardiogenic shock trial. • How mechanical circulatory support expanded despite limited evidence.2. The DANGER Trial – Impella in AMI-Associated Cardiogenic Shock • Mechanism and function of the Impella device. • Trial results: 20% mortality reduction at 180 days. • Complications: Limb ischemia, hemolysis, and high costs. • Real-world application: Who actually qualifies?3. ECLS-SHOCK Trial – ECMO for Cardiogenic Shock • A "negative" trial, but a crucial wake-up call. • No mortality benefit but significantly higher complication rates. • Controversies: Inclusion of cardiac arrest patients and transition to destination therapy. • Future directions: Can patient selection improve outcomes?4. ECPR – Extracorporeal Support in Refractory Cardiac Arrest • Review of the ARREST, PRAGUE, and INCEPTION trials. • Why the evidence remains unclear and institution-dependent. • The role of high-volume ECMO centers and standardized pathways.5. The Future of ECLS – Cost, Ethics, and Decision-Making • How should institutions decide who gets ECMO? • The role of cardiogenic shock teams. • Could AI play a role in decision-making? • The challenge of resource allocation in a single-payer system.Key Takeaways:✅ Impella shows promise in carefully selected AMI shock patients but is costly and high-risk.✅ ECMO for cardiogenic shock remains controversial—patient selection is key.✅ ECPR is promising but needs further trials and structured implementation.✅ Cardiogenic shock management should be a team decision, not an individual one.

In this World Shared Practice Forum podcast, Dr. Dennis Daniel discusses pediatric extracorporeal life support (ECLS) with experts Drs. Peta Alexander and Ryan Barbaro. They explore the differences between pediatric and adult extracorporeal cardiopulmonary resuscitation (ECPR), highlighting differing causes of cardiac arrest and the interpretation of recently published studies. The discussion also covers supply chain issues affecting ECMO availability, the importance of standardized, evidence-based practices to identifying ECMO-associated complications, and opportunities for future research into ECMO use and outcomes. LEARNING OBJECTIVES - Identify the key differences between pediatric and adult extracorporeal cardiopulmonary resuscitation (ECPR), focusing on technical challenges and typical causes of cardiac arrest - Discuss the challenges facing standardization of pediatric ECMO care, including supply chain issues and approaches to capturing and classifying ECMO-associated complications - Describe areas of need and opportunity for future research in pediatric ECMO AUTHORS Peta Alexander, MBBS, FRACP, FCICM Senior Associate Cardiologist Director of ECMO Program Boston Children's Hospital Associate Professor in Pediatrics Harvard Medical School Ryan Barbaro, MD, MSc Service Chief of Pediatric Critical Care Medicine Director of Pediatric ECMO C.S. Mott Children's Hospital Clinical Associate Professor in Pediatric Critical Care University of Michigan Dennis Daniel, MD ECMO Medical Director, Medical-Surgical ICU Associate Director, OPENPediatrics Boston Children's Hospital DATE Initial publication date: January 27, 2025. ARTICLES REFERENCED AND ADDITIONAL RESOURCES - Alexander PMA, Di Nardo M, Combes A, et al. Definitions of adverse events associated with extracorporeal membrane oxygenation in children: results of n international Delphi process from the ECMO-CENTRAL ARC. Lancet Child Adolesc Health. 2024;8(10):773-780. https://pubmed.ncbi.nlm.nih.gov/39299748/ - UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation. UK Collaborative ECMO Trail Group. Lancet. 1996;348(9020):75-82. https://pubmed.ncbi.nlm.nih.gov/8676720/ - Biomarkers of Brain Injury in Critically-Ill Children on Extracorporeal Membrane Oxygenation (ECMOhttps://reporter.nih.gov/project-details/10545733 - TITRE - Trial of Indication-based Transfusion of Red Blood Cells in ECMO, https://www.childrenshospital.org/clinical-trials/nct05405426 - ASCEND study: https://chear.org/our-research/projects/ascend-ards-children-and-ecmo-initiation-strategies-impact-neuro-development TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/bzpc2445cxrk9zch4wqvjjs5/012525_WSP_Updates_in_Pediatric_ECMO.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Alexander PMA, Barbaro RP, Daniel D. Updates in Pediatric ECMO: Challenges and Opportunities. 01/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/updates-in-pediatric-ecmo-challenges-and-opportunities-by-p-alexander-r-barbaro-openpediatrics.

Holger Thiele and C. Michael Gibson discuss the impact of VA-ECMO on patients with acute MI and advanced cardiogenic shock.

Event Objectives:Describe the varying forms of ECLS and understand the introductory nomenclature.Discuss the evolution of ECMO and the early challenges faced by scientists in creating this form of life support.Locate resources for your patients after they have been on ECLS should there be neurodevelopmental concerns.Claim CME Credit Here!

We heard about the patients journey through TPLO surgery last week. This week we talk with Veterinarian, Jay Brekke, as he goes through all of the advice and tips from the actual surgeons perspective. WATCH HERE Just how common is the CCL injury today? The odds of dealing with the injury and the underlying causes The knee certifications should be similar to the hip certifications The lifestyle and preventative measures while joins form as a puppy An egg a day....and other supplements From the injury in the field to the vet's office An X-ray or an MRI? TPLO or ECLS procedures. Theres also a TTA option The recovery process and advice Hardware considerations and the cost Sedative options The healing process and rehab options "Back to normal" activities The failure rate and the option to do both knees at one time Librela injections for arthritis Cytopoint for allergies Rehab Surgeon's information link discussed in the episode: www.TPLOinfo.com - Presented By: Standing Stone Supply | Check out their Online Courses and Use Code GDIY to save 15% onX Hunt Maps | Use Code: GDIY20 to save 20% Upland Gun Company | Midwest Double Gun Classic Marsh Wear Clothing | Use Code GDIY15 to save 15% (Patreon Patrons save even more) Trulock Choke Tubes | Use Code: GDIY10 to save 10% - Other Partners: BPro Kennels Eukanuba [What I Feed My Dogs: Premium Performance 30/20] Bird Dog Society - GDIY Links: Patreon | Instagram | Facebook | Website Learn more about your ad choices. Visit megaphone.fm/adchoices

PerfWeb 98 continues its educational journey into Day 2, focusing on the pivotal aspects of Extracorporeal Life Support (ECLS) and its adverse effects. Scheduled for Tuesday, March 19, 2024, this session is a crucial convergence for perfusionists, offering deep dives into the complexities and challenges associated with ECLS treatments. Endorsed with 1.2 Category 1 CEUs by the American Board of Cardiovascular Perfusion (ABCP), this seminar underscores the commitment to providing cutting-edge education and fostering a deeper understanding of critical care in perfusion practices. Event Overview Date: Tuesday, March 19, 2024 Time: 1700-1900 PerfWeb 98—Day 2 is singularly designed to enrich the knowledge base of perfusionists with a comprehensive exploration of ECLS. This session aims to equip professionals with the insights needed to navigate the adverse effects of ECLS, enhancing patient care and outcomes. The seminar is an essential platform for those in the field seeking to bolster their expertise, stay updated with the latest research, and engage in meaningful discussions on overcoming ECLS challenges. Session Details Adverse Effects of ECLS Faculty: V. Carlyle, RN, BSN-CCRN The session will be led by V. Carlyle, RN, BSN-CCRN, a distinguished figure in the field of critical care nursing with extensive experience in ECLS. Carlyle's presentation is set to cover the gamut of potential adverse effects associated with ECLS, including but not limited to thrombosis, bleeding, infection, and neurological complications. The session aims to not only outline these challenges but also to delve into preventive strategies, management techniques, and the latest research findings that can help mitigate these adverse effects. Participants will have the opportunity to engage in an interactive discussion, sharing experiences, strategies, and questions related to ECLS complications. This collaborative environment is designed to foster a community of learning and support among perfusionists and critical care professionals. CEU Accreditation This session has received the approval of 1.2 Category 1 CEUs by the ABCP, validating its educational merit and relevance to the perfusion community. This accreditation ensures that participants are recognized for their dedication to advancing their knowledge and skills, contributing to their professional development and the quality of care provided to patients. Why Attend? Expert Insights: Gain valuable knowledge from an experienced professional in the field of critical care and ECLS, enhancing your understanding of the adverse effects and management strategies. CEU Accreditation: Earn 1.2 Category 1 CEUs approved by the ABCP, supporting your professional development and maintaining your certification. Collaborative Learning: Benefit from the shared experiences and strategies of peers, enriching your practice and problem-solving skills. Critical Updates: Stay informed on the latest research and developments in ECLS, ensuring your practice is aligned with current standards and best practices. Registration and Participation Advance registration is encouraged for those planning to attend PerfWeb 98—Day 2. Complete details on how to register, including any associated fees, can be found on the official event website. Participants will also have access to post-event session recordings, offering flexibility in engaging with the material at their convenience. PerfWeb 98—Day 2 is an indispensable opportunity for perfusionists to deepen their understanding of ECLS, confront its adverse effects, and explore innovative solutions for enhancing patient outcomes. This seminar promises to be a valuable addition to the educational calendar of any perfusionist committed to excellence in their field. Join us on March 19, 2024, to partake in an educational experience that will shape the future of perfusion practices and patient care across North America.

Impact of Cardiac Arrest Before Randomization on the Efficacy of ECLS in Patients With Infarct-Related Cardiogenic Shock. A Sub-Analysis of the Prospective EClS-Shock Trial (AHA 2023)

In this episode, we discuss the recently published RCT "ECLS-Shock" trial in NEJM. This trial tested the benefit of instituting early extra-corporeal support in cardiogenic shock and suggested more harm in intervention arm compared to control arm. 

Episode 21! In this episode we talk about "Extracorporeal Life Support in Infarct-Related Cardiogenic Shock" published August 2023 by Thiele et al in NEJM. Then we dive into our neglected mail bad to try to answer some listener questions.ECLS-SHOCK: https://pubmed.ncbi.nlm.nih.gov/37634145/Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!

Witam Państwa, nazywam się Jarosław Drożdż, pracuję w Centralnym Szpitalu Klinicznym Uniwersytetu Medycznego w Łodzi, skąd nagrywam podcast Kardio Know-How. W tym odcinku kontynuujemy omawianie doniesień z Kongresu ESC.Szczegółowy TRANSKRYPT do odcinka.Podcast jest przeznaczony wyłącznie dla osób z profesjonalnym wykształceniem medycznym.

Association Between Enteral Feeding and Gastrointestinal Complications in Children Receiving ECLS by ASPEN Podcasts

Carlos Aurélio Santos AragãoGraduado em medicina pela Universidade Federal de Sergipe (UFS). Mestre pela USP/ IDPC. Residência de Clínica Médica no Instituto de Assistência Médica ao Servidor Público Estadual de São Paulo - IAMSPE/ SP. Residência médica em Cardiologia clínica pelo Instituto Dante Pazzanese de Cardiologia. Titulado especialista em Cardiologia pela Sociedade Brasileira de Cardiologia (SBC). Especialista em Insuficiência Cardíaca e Transplante Cardíaco pelo InCor-HCFMUSP.A emergência é desafiadora, exige essas habilidades em um pacote só, e o nosso paciente, diversas vezes, não tem tempo, ele precisa de todos esse anos de conhecimento agora. O Clube da Cardio convida você a continuar se preparando SEMPRE para esse momento. “Como?” Com o SAFER, o método de ensino de emergências cardiovasculares do Clube da Cardio. Transforme seu conhecimento e sua prática com o SAFER e seja referência. Seja excelente! Torne-se EXCELENTE AGORA

Biz acilciler olarak monitör, ritim, oksijen ve bağırma seslerine alışık ve bir yerde bunlara bağışıklılık kazanmış bir topluluk olsak da bir nöbette en fazla hangi hasta seni ajite eder sorusunu sorsalar hiç düşünmeden ağzında oksijen maskesiyle alana giren yaşlı bir hasta ve 112 ekipleri tarafından söylenen o 3 kelime: "hocam solunum sıkıntısı." derim. "Pnömoni, emboli, hipertansif akciğer ödemi, KOAH alevlenme… siyanotik hasta, bilinç konfüze... Entübasyon?? Non-invazivle düzelebilir mi?? Ajite de gözüküyor, ketamin mi versem??" Senaryoları kafamın içinde canlanır ve bu aşamalar geçilip hasta stabil edilse de muhtemelen yatış ihtiyacı olacağından konsültan ve boş yatak arayışları başlar. 7 büyük günahı işlettiren bir hasta ve bu hastaların belki de en kritiği ve son aşaması Akut Solunum Sıkıntısı Sendromu (Acute Respiratory Distress Syndrome-ARDS). GİRİŞ European Society of Intensive Care Medicine (ESICM) tarafından en son 2017'de yayınlanan ARDS klinik uygulama kılavuzunun güncellemesi özelliğini taşıyan kılavuz 2023 Mayıs ayının ortalarında yayınlandı. Öneriler ve çalışmalar erişkin hastalarda ve korona virüse bağlı gelişen ARDS'li hastalarda yapıldı. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) yönetimiyle yapılan incelemeler, GRADE sistemiyle derecelendirilen çalışmada: tanım; fenotipleme; Yüksek Akım Oksijen Tedavisi (HFNO); non invaziv mekanik ventilasyon (NIV); tidal hacim ayarları; pozitif ekspiryum sonu basıncı (PEEP); prone pozisyonu; ekstrakorporeal yaşam desteği (ECLS) gibi ana başlıklar olmak üzere 21 soruya 21 öneri sunularak panel sonlandırıldı.  Yoğun Bakım Ünitesi'ne yatışların %10'u, mekanik ventilasyona bağlı hastaların %23'ü gibi yüksek oranda görülen ve şiddetli ARDS olarak tanımlanan kategoride %45 mortalitelere ulaşan bir hastalığın kardiyak arrest kadar iyi tanınması ve yönetilmesi gerektiğini düşündüğümden kılavuz önerilerine geçmeden önce ARDS'den kısa olmayan bir özet şeklinde bahsedecek ve kılavuz önerilerini yazının ikinci bölümünde yer vereceğim.​1​ TANIM Sepsis, pnömoni, toksisite gibi çeşitli nedenlerden kaynaklanan inflamasyonun; yaygın alveolar hasar, azalmış akciğer kompliyansı ve endotel hasarı ile seyretmesi sonucu yüksek konsantrasyonda O2 uygulanmasına rağmen refrakter hipoksemi ile karakterize akut hipoksemik solunum yetmezliğine ARDS denilir.​2​ ETİYOLOJİ ARDS'nin 60'dan fazla olası nedeni tanımlansa da; sepsis, pnömoni ve aspirasyon %87'lik insidansla etiyoloji arayışında işimizi kolaylaştırmaktadır. Esasında ARDS'de çeşitli etiyolojik faktörlerin akciğer üzerinde benzer hasara ve benzer klinik özelliklere neden olduğu varsayılsa da çalışmalar farklı etiyolojik faktörlerin farklı seviyede prognozu olduğunu göstermektedir.​3​ Sepsis: ARDS'nin en yaygın nedenidir. Ciddi enfeksiyona eğilimli bir hastada veya yeni başlangıçlı ateş veya hipotansiyonla ilişkili ARDS geliştiğinde ilk sebep olarak akla gelmelidir. Aspirasyon: Mide içeriğinin aspirasyonu olduğu bilinen hastanede yatan hastaların üçte birinde ARDS gelişmektedir. Zamanında Mendelson tarafından yapılan çalışmada aspire edilen içeriğin ARDS'ye sebep olabilmesi için 2,5'tan daha düşük pH'a sahip olması gerektiği söylense de yapılan çalışmalar asidik olmayan mide içeriğinin de enzimler ve gıda parçaları vasıtasıyla akciğer hasarı yapabildiğini göstermiştir. Pnömoni: Toplum kökenli pnömoni (TKP), ARDS'nin hastane dışı en yaygın nedenidir. Bir hastada öksürük, plöritik ağrı, ateş ve lökositozun eşlik ettiği ARDS etiyolojik olarak pnömoniyi düşündürür. Yüksek Enerjili Travma: ARDS şiddetli travmanın bir komplikasyonudur. ARDS etiyolojisinin %10'luk kısmını travma oluşturur. Özellikle künt travmayı takiben gelişen bilateral akciğer kontüzyonu, uzun kemik kırıklarından 12-48 saat sonra gözüken yağ embolisi, şiddetli yanıklardan sonra görülen şok tablosu en yaygın mekanizmalardır. Yaşlılık, steroid kullanımı, yaralanma şiddeti skoru (ISS) yüksek olması,

JAMA Pediatrics Editors' Summary by Dimitri A. Christakis, MD, MPH, Editor in Chief, and Alison A. Galbraith, MD, MPH, Associate Editor, for the June 6, 2023, issue. Related Content: Cost-effectiveness and Return on Investment of a Nationwide Case-Finding Program for Familial Hypercholesterolemia in Children in the Netherlands Association Between Early Prostacyclin Therapy and Extracorporeal Life Support Use in Patients With Congenital Diaphragmatic Hernia

In this episode Jon Marinaro joins the ED ECMO team and interviews his colleague Sundeep Guliani, MD about the use of an ECMO first strategy for Massive Pulmonary Embolism. Jon and Sundeep review the data and processes from their institution and from other institutions in the United States.  Could it be that ECLS could move the survival needle on this high mortality disease? Listen and find out! Hobohm L, Sagoschen I, Habertheuer A, Barco S, Valerio L, Wild J, Schmidt FP, Gori T, Münzel T, Konstantinides S, Keller K. Clinical use and outcome of extracorporeal membrane oxygenation in patients with pulmonary embolism. Resuscitation. 2022 Jan;170:285-292. doi: 10.1016/j.resuscitation.2021.10.007. Epub 2021 Oct 12. PMID: 34653550. Shinar Z, Hutin A. Pulmonary ECMO-ism: Let's add PEA to ECPR indications. Resuscitation. 2022 Jan;170:293-294. doi: 10.1016/j.resuscitation.2021.11.004. Epub 2021 Nov 10. PMID: 34774708. Pudil J, Rob D, Smalcova J, Smid O, Huptych M, Vesela M, Kovarnik T, Belohlavek J. Pulmonary embolism related refractory out-of-hospital cardiac arrest and extracorporeal cardiopulmonary resuscitation: Prague OHCA study post- hoc analysis. Eur Heart J Acute Cardiovasc Care. 2023 May 12:zuad052. doi: 10.1093/ehjacc/zuad052. Epub ahead of print. PMID: 37172033. Karami M, Mandigers L, Miranda DDR, Rietdijk WJR, Binnekade JM, Knijn DCM, Lagrand WK, den Uil CA, Henriques JPS, Vlaar APJ; DUTCH ECLS Study Group. Survival of patients with acute pulmonary embolism treated with venoarterial extracorporeal membrane oxygenation: A systematic review and meta-analysis. J Crit Care. 2021 Aug;64:245-254. doi: 10.1016/j.jcrc.2021.03.006. Epub 2021 Mar 24. PMID: 34049258.

Le Pr Bruno Mégarbane qui travaille à l'Hôpital Lariboisière nous parle de l'intoxication aux cardiotropes. Aucun conflit d'intérêt n'est déclaré. Sommaire Quelles sont les manifestations les plus courantes d'une intoxication aux bêtabloquants et quelle prise en charge proposez vous ? Concernant les intoxications aux inhibiteurs calciques, pouvez-vous nous détailler les deux catégories d'intoxications (dihydropyridines ou non) et leurs prises en charge ? Concernant les intoxications aux digitaliques, quelle est la présentation la plus fréquente et la prise en charge recommandée ? Quelle est la place de l'ECLS dans les intoxications aux cardiotropes ? (Je me souviens d'un cours de DESC où vous abordiez cette notion, et notamment celle de l'optimisation de la précharge avant l'éventuelle pose d'une ECLS)

Connor Bedard leads Corey Pronman's final 2023 NHL Draft rankings, but who else should Arizona Coyotes fans know outside of Bedard and Adam Fantilli? Is the headline for this year's draft still: The big 4 and the rest? The Athletics NHL prospects analyst Corey Pronman joins the PHNX Coyotes podcast to break down the 2023 draft class. 0:00 Intro 1:10 Corey's latest prospect list 6:10 Who has hurt their draft stock 7:10 How Connor Bedard compares to Shane Wright 10:30 The landscape surrounding Matvei Michkov 16:43 Is Leo Carlsson a high-end talent? 18:25 Redrafting the 2022 top-5 20:20 Thoughts on Will Smith 22:10 Projections for Slovakia's Dalibor Dvorsky 24:10 D prospect Tom Willander 25:30 Moose Jaw's Brayden Yager 27:00 Vancouver & Slovakia's Samuel Honzek 28:15 Can the Yotes get a good player? 32:15 Reacting to Corey's analysis 43:25 Ratu, Szuber sign ECLs, Cooley undecided 45:50 Calder finalists announced today 48:15 Thoughts on NHL playoffs 49:15 TED vote update An ALLCITY Network Production WATCH YOUR FAVORITE TEAMS HERE: https://www.fubotv.com/phnx SUBSCRIBE to our YouTube: https://bit.ly/phnx_youtube ALL THINGS PHNX: http://linktr.ee/phnxsports Keepin It 100 Golf Scramble: https://www.eventbrite.com/e/phnx-keepin-it-100-classic-scramble-golf-tournament-tickets-617328515207 Gametime: Download the Gametime app, create an account, and use code PHNX for $20 off your first purchase. Manscaped: Save 20% Off and Free Shipping with the code “PHNX” at Manscaped.com. BetMGM: Download the BetMGM app and sign-up using bonus code PHNX (betmgm.com/phnx). Place a pre-game, moneyline wager in the amount of at least $10 on any market at standard odds price. You will receive $200 in Bonus Bets instantly regardless of the outcome of your wager! Just make sure you use bonus code PHNX when you sign up! Gambling problem? Call 1-800-GAMBLER (CO, DC, IL, IN, LA, MD, MS, NJ, OH, PA, TN, VA, WV, WY). Call 877-8-HOPENY or text HOPENY (467369) (NY). Call 1-800-327-5050 (MA) 21+ to wager. Please Gamble Responsibly. Call 1-800-NEXT-STEP (AZ), 1-800-522-4700 (KS, NV), 1-800-BETS-OFF (IA), 1-800-270-7117 for confidential help (MI). Visit BetMGM.com for Terms & Conditions. US promotional offers not available in DC, Nevada, New York or Ontario. Knockout Nights: Join our cornhole league during the 1st Friday night of every month! They're free to enter and will include food and beverage specials, giveaways, and BetMGM prizes: https://www.eventbrite.com/e/622016186157 Pins & Aces: Check out pinsandaces.com and use code PHNX to receive 15% off your first order and get free shipping. PHNX: Join us at the BetMGM Sportsbook at State Farm Stadium for all Suns' away playoff games. Our PHNX Suns watch parties, presented by NUTRL, will feature food and drink specials, PHNX giveaways, and BetMGM deposit matches. Join us by grabbing your free ticket: https://www.eventbrite.com/e/616706063437 Four Peaks: Enjoy a refreshing Four Peaks' Red Bird Lager during the NFL Draft on April 27th. Must be 21+. Enjoy responsibly. Circle K: Text PHNX to 31310 to join the Circle K SMS subscriber club and get BOGO 32 oz Polar Pops! Head to https://www.circlek.com/store-locator to find Circle Ks near you! OGeez!: Learn more about OGeez! at https://ogeezbrands.com//. Must be 21 years or older to purchase. Roman: Go to https://ro.co/PHNX today to get 20% off your entire first order. When you shop through links in the description, we may earn affiliate commissions. Copyright Disclaimer under section 107 of the Copyright Act 1976, allowance is made for “fair use” for purposes such as criticism, comment, news reporting, teaching, scholarship, education and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode we discuss the HOPE score, a tool that improves our ability to select the severely hypothermic patients who can benefit from warming with extracorporeal life support (ECLS). We begin the with the case of Tayyab Jafar, a young man who was successfully resuscitated from severe hypothermia with both cardiopulmonary bypass and ECMO, but not without incident.  We then discuss the derivation and validation studies for the HOPE score. You can calculate and use the HOPE score at HypothermiaScore.org.HOPE score derivation PDFHOPE score validation: not freely availableAs always, thanks for listening to Wilderness Medicine Updates, hosted by Patrick Fink MD. Connect with us by email at wildernessmedicineupdates@gmail.com.You can pay us a compliment and share the show with a new listener on any popular platform here.

Most have been hearing about Expected credit loss(ECLs) for a very long time it's been doing the rounds for almost a month. Now, what exactly is ECL and why is the RBI looking and implementing it in Indian banks at this juncture? Crisil's Arunkumar Iyer, Senior Director explains. Listen in! --- Send in a voice message: https://podcasters.spotify.com/pod/show/business-line/message

In this episode,  Dr. Gillian Beauchamp sits down with Dr. Susanna Byram to discuss the use of VV and VA ECMO and other Mechanical Circulatory Support Devices in poisoned patients. 

Lung transplantation for patients with interstitial lung disease including Idiopathic Pulmonary Fibrosis and Connective Tissue Disease.Victoria Rusanov MD discusses lung transplantation for patients with interstitial lung disease including Idiopathic Pulmonary Fibrosis and Connective Tissue Disease. She shares the importance of objectively assessing clinical decline and early referrals to transplant center. She offers information on the management of the patient during a flare and advanced life support like ECLS as bridge to transplant.

Today we're going to talk about ECMO/ECLS and how it intersects with prehospital medicine. ECMO is the acronym for extra-corporeal membrane oxygenation and ECLS is extra-corporeal life support.  Please join the UCSF-Fresno team as they discuss this new and exciting topic with special guest Dr. Crystal Ives-Tallman.

WMS Çığ İlişkili ve İlişkisiz Kar Altında Kalma Kazalarına Yaklaşım Kılavuzu (2017)​1​ Wilderness Medical Society’nin 2017’de yayınladığı çığ ilişkili ve ilişkisiz kar altında kalma kazalarına yaklaşım kılavuzunun ikinci kısmı olan “resüsitasyon” bölümü ile tekrar karşınızdayız. Kılavuzun birinci kısmına buradan ulaşabilirsiniz. Çığ Altında Kalmış Hastada Resüsitasyon Çığ bölgesinde resüsitasyon zorlu olabilir. Bir kurtarıcının, sınırlı ekipman ve personelin bulunduğu zorlu bir ortamda kardiyopulmoner resüsitasyon (KPR) ve ileri yaşam desteğine (İYD) başlanması gerekebilir. Eğer baş ve göğüs açıktaysa vücut tamamen çıkarılmadan önce resüsitasyon başlatılabilir. Çığ altında kalan hastalarda sağkalım için prognostik faktörler, varsa yaralanmanın ciddiyeti, gömülme süresi, hava yolu açıklığı, vücut sıcaklığı ve sahada imkan varsa serum potasyum düzeyidir. Yakın zamandaki retrospektif gözlemsel çalışmalar, uzun süreli KPR ve ekstrakorporeal yaşam desteği (ECLS) alan çığ kurbanlarının hayatta kalma oranlarının %11 gibi düşük bir düzeyde olduğunu bulmuştur.  Kılavuzun uzun süreli KPR ve ECLS kriterlerini 2015 ERC kılavuzunda belirtildiği gibi anlatmış olması sebebiyle bu yazı 2020 kılavuzu ile teyit edilerek hazırlanmıştır. Kılavuzlar beyhude resüsitasyon çabasını ve arama kurtarma esnasındaki değerli iş gücü ve kaynak kaybını önlemek adına hipotermik resüsitasyon eşiğini 30 C kor sıcaklığı sınırına koymuştur. Bu değerleri aşan vakaların nörolojik sağkalım ihtimalinin oldukça düşük olduğu belirtilmektedir. Yaralanma olmaksızın tamamen kar altında kalma Eğer hasta gömülme sonrasında halen alert ise özellikle 30 dakika sonrasında hipotermi gelişmesi muhtemeldir. Vücut cevap olarak termoregülasyon sonrasında titreme ile tekrar ısınma sağlayabilir. Bu hastalarda nadir de olsa pulmoner ödem görülebilir. Etyoloji negatif basınca bağlı pulmoner ödem ile hipoksiye bağlı sol kalp yetmezliğinin birlikte görülmesi olarak açıklanmaktadır. Öneri. Tamamen gömülmüş hastalar, hiç yaralanma olmaksızın çıkarılmış olsalar da, hasta stabilize edebilecek bir merkeze nakledilmelidir (Ö.D. 2C). Travma yönetimi Travma asfiksi ve hipotermiyi derinleştirebilir. Olası kafa travmaları, spinal yaralanmalar ve uzun kemik kırıkları genel kabul görmüş uygulamalarla değerlendirilebilir. Öneri: Olası spinal yaralanmalar NEXUS veya Canadian C-Spine Rules kılavuzlarına göre yönetilebilir (Ö.D. Uzman Fikir Birliği). Hipotermi yönetimi Çığ altında kalmış soğuk ve bilinci kapalı hastada orta veya ağır hipotermiden şüphelenilmelidir. Öneri. Çığ altında kalmış hastalarda hipoterminin yönetilmesi WMS veya ERC kılavuzlarına göre yürütülmelidir (Ö.D. Uzman Fikir Birliği). Resüsitasyonun başlatılması Çığ altından çıkarılan tüm hastalar hava yolu açıklığı, solunum ve dolaşım açısından değerlendirilmeli ve KPR yapmama endikasyonu yoksa, gerekli tüm hastalara KPR başlatılmalı ve kurtarıcı eğitimli ise ileri İYD uygulanmalıdır. Eğer çığ altında gömülü kalma süresi 60 dakikadan az ve kor sıcaklığı 30C’den yüksek ise kardiyak arrest büyük ihtimalle ya travmaya ya da asfiksiye bağlı olabilir. Bu hastalarda ısıtmaya gerek yoktur ve 30 dakikalık KPR ile spontan dolaşımın geri dönüşü sağlanamazsa sağ kalım şansı oldukça düşüktür ve resüsitasyon çabaları sonlandırılabilir (Şekil 1). Eğer çığ altında kalma süresi 60 dakikanın üzerinde, kor sıcaklığı 30 C’den düşük ve hastanın hava yolu da açık ise kardiyak arrest hipotermiye bağlı olabilir ve ekstrakorporeal ısıtma endikasyonu vardır. Ancak çığ altından kurtarıldıktan sonra kardiyak arrest olan hastaların yaşama ihtimalinin çığ altındayken (tanıksız) kardiyak arrest olan hastalara göre daha yüksek olduğu unutulmamalıdır. Özellikle tanıklı ve/veya hipotermiye bağlı kardiyak arrestlerde KPR süresini 30 dakikanın üzerine uzatma endikasyonu vardır. Eğer kor sıcaklığı 30 C altında ve şoklanabilir bir ritm varsa defibrilasyon başarısız olabilir.

WMS Çığ İlişkili ve İlişkisiz Kar Altında Kalma Kazalarına Yaklaşım Kılavuzu (2017)​1​ Wilderness Medical Society’nin 2017’de yayınladığı çığ ilişkili ve ilişkisiz kar altında kalma kazalarına yaklaşım kılavuzunun ikinci kısmı olan “resüsitasyon” bölümü ile tekrar karşınızdayız. Kılavuzun birinci kısmına buradan ulaşabilirsiniz. Çığ Altında Kalmış Hastada Resüsitasyon Çığ bölgesinde resüsitasyon zorlu olabilir. Bir kurtarıcının, sınırlı ekipman ve personelin bulunduğu zorlu bir ortamda kardiyopulmoner resüsitasyon (KPR) ve ileri yaşam desteğine (İYD) başlanması gerekebilir. Eğer baş ve göğüs açıktaysa vücut tamamen çıkarılmadan önce resüsitasyon başlatılabilir. Çığ altında kalan hastalarda sağkalım için prognostik faktörler, varsa yaralanmanın ciddiyeti, gömülme süresi, hava yolu açıklığı, vücut sıcaklığı ve sahada imkan varsa serum potasyum düzeyidir. Yakın zamandaki retrospektif gözlemsel çalışmalar, uzun süreli KPR ve ekstrakorporeal yaşam desteği (ECLS) alan çığ kurbanlarının hayatta kalma oranlarının %11 gibi düşük bir düzeyde olduğunu bulmuştur.  Kılavuzun uzun süreli KPR ve ECLS kriterlerini 2015 ERC kılavuzunda belirtildiği gibi anlatmış olması sebebiyle bu yazı 2020 kılavuzu ile teyit edilerek hazırlanmıştır. Kılavuzlar beyhude resüsitasyon çabasını ve arama kurtarma esnasındaki değerli iş gücü ve kaynak kaybını önlemek adına hipotermik resüsitasyon eşiğini 30 C kor sıcaklığı sınırına koymuştur. Bu değerleri aşan vakaların nörolojik sağkalım ihtimalinin oldukça düşük olduğu belirtilmektedir. Yaralanma olmaksızın tamamen kar altında kalma Eğer hasta gömülme sonrasında halen alert ise özellikle 30 dakika sonrasında hipotermi gelişmesi muhtemeldir. Vücut cevap olarak termoregülasyon sonrasında titreme ile tekrar ısınma sağlayabilir. Bu hastalarda nadir de olsa pulmoner ödem görülebilir. Etyoloji negatif basınca bağlı pulmoner ödem ile hipoksiye bağlı sol kalp yetmezliğinin birlikte görülmesi olarak açıklanmaktadır. Öneri. Tamamen gömülmüş hastalar, hiç yaralanma olmaksızın çıkarılmış olsalar da, hasta stabilize edebilecek bir merkeze nakledilmelidir (Ö.D. 2C). Travma yönetimi Travma asfiksi ve hipotermiyi derinleştirebilir. Olası kafa travmaları, spinal yaralanmalar ve uzun kemik kırıkları genel kabul görmüş uygulamalarla değerlendirilebilir. Öneri: Olası spinal yaralanmalar NEXUS veya Canadian C-Spine Rules kılavuzlarına göre yönetilebilir (Ö.D. Uzman Fikir Birliği). Hipotermi yönetimi Çığ altında kalmış soğuk ve bilinci kapalı hastada orta veya ağır hipotermiden şüphelenilmelidir. Öneri. Çığ altında kalmış hastalarda hipoterminin yönetilmesi WMS veya ERC kılavuzlarına göre yürütülmelidir (Ö.D. Uzman Fikir Birliği). Resüsitasyonun başlatılması Çığ altından çıkarılan tüm hastalar hava yolu açıklığı, solunum ve dolaşım açısından değerlendirilmeli ve KPR yapmama endikasyonu yoksa, gerekli tüm hastalara KPR başlatılmalı ve kurtarıcı eğitimli ise ileri İYD uygulanmalıdır. Eğer çığ altında gömülü kalma süresi 60 dakikadan az ve kor sıcaklığı 30C’den yüksek ise kardiyak arrest büyük ihtimalle ya travmaya ya da asfiksiye bağlı olabilir. Bu hastalarda ısıtmaya gerek yoktur ve 30 dakikalık KPR ile spontan dolaşımın geri dönüşü sağlanamazsa sağ kalım şansı oldukça düşüktür ve resüsitasyon çabaları sonlandırılabilir (Şekil 1). Eğer çığ altında kalma süresi 60 dakikanın üzerinde, kor sıcaklığı 30 C’den düşük ve hastanın hava yolu da açık ise kardiyak arrest hipotermiye bağlı olabilir ve ekstrakorporeal ısıtma endikasyonu vardır. Ancak çığ altından kurtarıldıktan sonra kardiyak arrest olan hastaların yaşama ihtimalinin çığ altındayken (tanıksız) kardiyak arrest olan hastalara göre daha yüksek olduğu unutulmamalıdır. Özellikle tanıklı ve/veya hipotermiye bağlı kardiyak arrestlerde KPR süresini 30 dakikanın üzerine uzatma endikasyonu vardır. Eğer kor sıcaklığı 30 C altında ve şoklanabilir bir ritm varsa defibrilasyon başarısız olabilir.

Further evidence for the use of the EarlyCDT Lung blood test in lung cancer screening Dr Adam M Hill, CEO of Oncimmune, said: "Following last week's announcement of the publication of the ECLS trial in the European Respiratory Journal, we are delighted to see these additional abstracts presented online. "Beyond proving the ability of the EarlyCDT Lung blood test to detect cancer earlier in a screening population, it is also important to assess the negative impacts of using the test in the population, and the costs of implementing the diagnostic. These findings will no doubt assist our ongoing commercial discussions with health authorities in the UK and in other territories, and we look forward to the peer reviewed publications in due course."

Adam talks to Professor Frank Sullivan, Professor of Primary Care Medicine at the University of St. Andrews and Chief Investigator for the Early detection of Cancer of the Lung Scotland (ECLS) trial. Frank talks about the challenges of managing cancer in some of the most deprived communities in the country, why lung cancer specifically, is so difficult to diagnose and why the results of the ECLS trial are so significant. Adam and Frank also discuss the role that the EarlyCDT Lung blood test could play in helping to overcome the excess burden of undiagnosed cancers we're seeing as a result of the COVID crisis.

COVID-19 has resulted in changes to loan agreements and payment schedules. How should these changes be accounted for in IFRS 9, Financial instruments? Marie Kling talks through modification, ECLs, business model assessments and more.

Continuing on the theme from the last two episodes we're looking at how ECLS can apply in pregnant patients.     

Extracorporeal Membrane Oxygenation (ECMO)Special Guest: Amy Dzierba, PharmD, FCCM, FCCP, BCCCP Show Notes: https://pharmacytodose.files.wordpress.com/2020/01/ecmo-show-notes.pdfShow References: https://pharmacytodose.files.wordpress.com/2020/01/ecmo-references.pdf 00:25 - #PharmacyToRead Announcement!; 07:50 – Why is Amy interested in ECMO?; 11:48 – What is ECMO and when did we start using ECMO in the US?; 13:45 – ECLS v. ECMO; 15:52 – Why are we talking about ECMO today?; 19:40– What does ECMO do?; 21:05 – ECMO modalities; 22:59 – ECMO equipment; 27:30 – What should be tried before ECMO?; 30:56 – ECLS effect on PK/PD; 40:05 – Tips/tricks on ECMO anticoagulation, infection, and sedation protocols; 40:45 – Anticoagulation protocols; 47:30 – Infection protocols; 53:15 – Sedation protocols; 58:18 – ECMO complications; 60:40 – Tips when creating or modifying ECMO protocols; 63:27 – Future areas of ECMO research; 65:00 – Take-home pointsPharmacyToDose.Com@PharmacyToDose on Twitter/InstagramPharmacyToDose@Gmail.com

The use of ECMO therapy is increasing in today’s critical care environment, so this course is designed to be a basic introduction to extracorporeal membrane oxygen support therapy or ECMO.  We will discuss the What, How, Why and When of implementing ECMO therapy as well as common complications encountered during ECMO.  Case Studies will be incorporated as well as discussion differentiating between ECLS and ECPR.   The information provided will be based upon the ExtraCorporeal Life Support Organization (ELSO) recommendations for best practice with ECMO support.

Host Aaron N. Leetch, MD sits down with Jarrod Mosier, MD to discuss Extracorporeal Life Support (ECLS). Dr. Mosier is an Associate Professor with Tenure of Emergency Medicine at the University of Arizona College of Medicine - Tucson. Dr. Mosier's research interests are advanced airway management, critical care ultrasound, and extracorporeal cardiopulmonary resuscitation.

Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine

Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine

International outcomes of centres performing ECLS (extracorporeal life support) are highly variable due to differences in patient selection, cannulation technique, practitioner experience and hospital volume. We describe the experience of one of the first regional intensive care units in Australia to provide both VV (veno-venous) and rescue VA ECMO (veno-arterial extra-corporeal membrane oxygenation).   Methods  Review of internal registry and description of processes and procedures in an 11 bed regional general ICU without on-site cardiothoracic surgery.  Results  Over a 3.5 year period 21 patients received ECLS (90 ECMO days) with an overall 55% survival. All cannulations were peripheral. 4 patients were retrieved from peripheral site. 8 patients subsequently transferred to quaternary centre. Overall survival for VV ECMO was 64% (n=11), rescue VA ECMO (n=12, 8 from E-CPR) 33% survival.   Conclusion  Provision of ECLS (extracorporeal life support) in large regional centres is possible with outcomes similar to high volume centres if established with realistic goals, limitations, and referral pathways to a supportive high volume referral centre. Advantages include timely establishment of life support without the inherent delays of long distance weather dependent aero-medical retrieval and ability to stabilise and prognosticate at the local site. Straight-forward VV-ECMO can be entirely provided at a regional site whilst highly complex patients can safely await further transfer. Regional ECLS provision facilitates appropriate patients receiving ECLS at an optimal time that minimises excessive morbidity.    

Extracorporeal membrane oxygenation assisted cardiopulmonary resuscitation (ECPR) is an effective therapy to improve outcomes for children who experience cardiopulmonary arrest. Survival after ECLS varies between 60% and 75%. For ECPR survival is lower, with 40% to 50% of children surviving ECPR. After ECPR good neurological outcomes are seen in 40% to 60% of children. This contrasts with adult patients where neurological outcomes after ECPR are poor. Given these findings the American Heart Association has included ECPR in their 2015 guidelines for children who experience an in hospital cardiac arrest (IHCA).  Several modifiable and non-modifiable factors have been identified as influencing outcomes after ECPR. Location (in-hospital versus out-of-hospital[OHCA]) of cardiac arrest as well as pre ECLS CPR duration impact survival. For children, OHCA is generally viewed as a contraindication. However patients who achieve intermittent output during their OHCA may still qualify for ECPR, particularly if they show signs of good cerebral perfusion during the CPR event. Whether the duration of pre ECLS CPR impacts survival is debated, with studies showing conflicting evidence for and against an observable effect. Duration of in-hospital CPR should therefore not serve as a decision making guide whether ECLS is offered to patients or not.   Post resuscitation care equally raises challenges: targeting normothermia has become a clinical standard, but what oxygenation (which can be independently selected via ECLS) should be aimed for remains unclear.  The organisational structure of a hospital-based ECPR program influences patient survival and must be tailored to the respective institution’s ECLS experience. ECPR eligibility should be anticipated, possibly for any patient entering the hospital. There must be clear agreements for inclusion and exclusion criteria, the latter including severe cerebral injury (hypoxic, metabolic or haemorrhagic), end stage terminal illness or uncontrollable haemorragic disease.  ECPR confers a clear survival benefit for children, but due to logistic requirements remains challenging to implement.

Talk will discuss the use of ECMO as advanced cardio-pulmonary resuscitation in the setting of refractory cardiac arrest.   The aim will be to provide useful information for those already experienced in ECPR as well as those with no experience but an interest in establishing an ECPR in their adult centre.   Topics covered will include the rationale for the use of ECPR , the evidence base and current Australasian practice.  Practical issues re patient selection , cannulation , post cannulation management of haemodynamics , monitoring and ongoing management of the ECPR patient will be covered.  Potential future directions for ECPR will conclude the talk. 

The adult ECLS/ECMO program at OHSU brings individualized care to patients whether they are in an OHSU intensive care unit, at a hospital outside of Portland or even while in the air, when working with Life Flight transport. OHSU is the only hospital in the Pacific Northwest offering air and ground transport for both pulmonary and cardiac adult ECMO patients. Guests include: David Zonies, M.D., M.P.H., F.A.C.S., F.C.C.M., associate professor of surgery, OHSU School of Medicine; associate professor, OHSU-PSU School of Public Health; director, ECLS Program Sean Freiss, R.N., B.S.N., C.C.R.N., adult ECLS coordinator

I’m just a Reanimatologist - Episode 3 This month’s episode explores the controversial topic of Emergency Department initiated extracorporeal membrane oxygenation (ECMO) and extracorporeal life support (ECLS). Dr. Jonathon Ford relives a challenging case of beta blocker and calcium channel blocker overdose. Then, we have a front row seat in the heated battle of words between Dr. John Rose and Dr. Dan Colby on the pros and cons of ED ECMO. Where do you stand? Join the conversation on Social Media @empulsepodcast or at https://ucdavisem.com Hosts: Dr. Sarah Medeiros, Assistant Professor of Emergency Medicine at UC Davis Dr. Julia Magaña, Assistant Professor of Emergency Medicine at UC Davis – Pediatric Emergency Medicine Guests: Dr. Jonathon Ford, Assistant Professor of Emergency Medicine, and Medical Toxicologist at UC Davis Health Dr. Dan Colby, Assistant Professor of Emergency Medicine, and Medical Toxicologist at UC Davis Health Dr. John Rose, Professor of Emergency Medicine at UC Davis Health, and EMS Medical Director for Yolo County Resources: Massive diltiazem and metoprolol overdose rescued with extracorporeal life support https://www.ncbi.nlm.nih.gov/pubmed/28705745 Chenoweth JA, Colby DK, Sutter ME, Radke JB, Ford JB, Nilas Young J, Richards JR. Am J Emerg Med. 2017 Oct;35(10):1581.e3-1581.e5. doi: 10.1016/j.ajem.2017.07.023. Epub 2017 Jul 6. PubMed PMID: 28705745. The ED ECMO Project and Podcast with Doctors Joe Bellezzo, Zack Shinar, and Scott Weingart. http://edecmo.org ECLS Registry Report on http://elso.org Thank you to the UC Davis Department of Emergency Medicine for supporting this podcast and to Orlando Magaña at OM Audio Productions for audio production services.

In this episode of the INTENSIVE podcast, Dr Paul Nixon talks about the indications for ECMO, the referral process, and where ECMO should take place. The target audience is general intensivists, trainees, and other health professionals who may need to refer patients for consideration of ECMO. Show notes are available at: http://intensiveblog.com/intensive-podcast-7/

Dr Tim Byrne provides an introduction to ECMO (extracorporeal membrane oxygenation). The target audience is registrars with limited previous ECMO experience. Show notes are available at: http://intensiveblog.com/intensive-podcast-6/

Greetings again from ECMOVember 2014!! Here is another lecture I gave at a recent ECMO training course. Today we have a picturesque look at the times when ECMO doesn’t go as planned…. My goal is that in 20 minutes I can show you that with some planning and prevention most of the ECMO-whoas ...

John Greenwood is a Critical Care Fellow at the University of Maryland where he also completed his Emergency Medicine residency. He is well known for publishing the EMRA Critical Care Handbook and the PressorDex. Here he discusses the circulatory reengineering at Bellevue grand rounds. Download Episode

In this episode Joe talks with Suzanne Chillcott, the Mechanical Circulatory Support (MCS) Lead RN at Sharp Memorial Hospital to discuss the nuts and bolts of establishing a "nurse-run" ECLS program. The post EDECMO Episode 12 – The Nurse-Based ECMO Program at Sharp Memorial Hospital with Suzanne Chillcott RN, BSN appeared first on ED ECMO.

This interview with Joe Bellezzo is what caused Scott to pursue ECLS. The post Resuscitative ECMO Interview from EMCrit.org appeared first on ED ECMO.

In this episode, Joe and Zack discuss some of the terminology and basics of ECMO and ECLS. The post Episode 1 – An Introduction to ECMO Terminology appeared first on ED ECMO.

Background: The number of patients presenting with acute myocardial infarction (AMI) and being untreatable by interventional cardiologists increased during the last years. Previous experience in emergency coronary artery bypass grafting (CABG) in these patients spurred us towards a more liberal acceptance for surgery. Following a prospective protocol, patients were operated on and further analysed. Methods: Within a two year interval, 127 patients (38 female, age 68 +/- 12 years, EuroScore (ES) II 6.7 +/- 7.2%) presenting with AMI (86 non-ST-elevated myocardial infarction (NSTEMI), 41 STEMI) were immediately accepted for emergency CABG and operated on within six hours after cardiac catheterisation (77% three-vessel-disease, 47% left main stem stenosis, 11% cardiogenic shock, 21% preoperative intraaortic balloon pump (IABP), left ventricular ejection fraction 48 +/- 15%). Results: 30-day-mortality was 6% (8 patients, 2 NSTEMI (2%) 6 STEMI (15%), p=0.014). Complete revascularisation could be achieved in 80% of the patients using 2 +/- 1 grafts and 3 +/- 1 distal anastomoses. In total, 66% were supported by IABP, extracorporal life support (ECLS) systems were implanted in two patients. Logistic regression analysis revealed the ES II as an independent risk factor for mortality (p