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ECMO for Pulmonary Hypertension

New GUIDELINES from a joint effort of the American Heart Association and American Thoracic Society specify the use of ECMO for Pulmonary Hypertension. For many years ECMOlogists have utilized ECMO for Pulmonary Hypertension of both the newborn as well as pediatric patients. Some have utilized ECMO for Pulmonary Hypertension in adults as well.  For the newborn […]

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Prone Positioning on VV ECMO

Prolonged prone positioning on VV ECMO has recently been reported as beneficial by Levy et al in Annals of Intensive Care.  We presented another blog post in November 2015 related to Prone Positioning on ECMO. Levy’s report does not show improved outcome directly, but unlike some other reports, he shows that by keeping the VV ECMO […]

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ECMO Outcomes Updated

ECMO Outcomes Updated Dec 2015 Are ECMO outcomes dependent on the number of ECMO patients supported at your institution?  Does it really matter how many ECMO patients your program supports?  Do patients suffer by being on ECMO at smaller ECMO programs? There have been a couple of publications recently suggesting that it does matter. A recent […]

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Prophylactic Antibiotic Use on ECMO

Prophylactic antibiotic use on ECMO has historically been a very common practice.  Many institutions are still practicing prophylactic antibiotic use on ECMO but is it justified? A review of the ELSO database published in PEDIATRIC CRITICAL CARE MEDICINE in May of 2011 highlighted an overall rate of 11.7% incidence of acquired infections on ECMO from 1998 to 2008.  It’s […]

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New 2015 ECPR Recommendations

New 2015 ECPR recommendations can be found buried in the 2015 American Heart Association guidelines for cardiopulmonary resuscitation. The recommendations are broken down into 3 primary age groups; Neonatal, Pediatric, Adult. Then further distinguished by In Hospital Cardiac Arrest (IHCA) and Out-of-Hospital Cardiac Arrest (OHCA). Overall general recommendations still state that there is insufficient evidence to […]

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Prone Positioning on ECMO

The recommendation of prone positioning on ECMO may put fear into the heart of the caregiver.  Thoughts of  inadvertent decannulation, extubation, excessive bleeding, kinked ECMO tubing… A recent article in RESPIRATORY CARE provided a review of 7 prospective studies or case reports that revealed very few complications related to prone positioning on ECMO.  There were […]

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Successful Support of Adult Myocarditis Using VA ECMO

A recent article in the Annals of Thoracic Surgery highlights successful support of Adult Myocarditis using VA ECMO.  Use of Adult ECMO has significantly increased over the last few years.  The benefits of using ECMO in various adult populations are still being proven. This article provides a nice overview of successful use for this special […]

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Blood Conservation Practices Impact ECMO

Should new blood conservation practices impact ECMO management?  Over the last few years we have seen multiple benefits from blood conservation measures across the OR and ICU environments.  But should we employ these measures to ECMO management? For many years, and still today, many ECMO order sets will direct caregivers to treat a HCT of […]

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Apnea Test on ECMO

A group in Poland has published a nice summary regarding how to perform an apnea test on ECMO. This discussion has also come up on eclsnet over the years. In order to perform a valid apnea test it is generally accepted that the patient’s CO2 must rise above 60 mm Hg (or increase by 20 mmHg above […]

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