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@ELSOOrg
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Extracorporeal Life Support Organization ELSO OFFICE 3001 Miller Road, Ann Arbor, MI, USA 48103 Phone: +1-734-293-2101
Ann Arbor, MI
Joined October 2013
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The new ELSO guidelines, describing
#ECMO
circuits for all
patient populations, adult and pediatric, are now available, open access on
@asaiojournal
These consensus guidelines describe safe practice based on extensive experience.
Download full text
#FOAMcc
1
111
221
#ECMO
Blood Flow & recirculation impact on thermodilution-based measurements of cardiac output, results from animal model study may suggest the futility of classic thermodilution-based technique during veno-venous
#ECLS
.
@asaiojournal
2
50
163
The ELSO interim guidelines for VA
#ECMO
in adult
📌 indications/contraindications
📌 configurations & peculiarities, cannulation, distal perfusion, left ventricular venting
📌 management/monitoring
📌 complications
📌 weaning
📌
#ethics
@asaiojournal
0
68
139
The
@ELSOOrg
guidelines for fluid overload, acute kidney injury, and electrolyte management on extracorporeal support in neonatal, pediatric and adult patients:
Just published on
@asaiojournal
open access, FOAMcc
#FOAMecmo
as all ELSO guidelines!
1
60
126
Early awakening & extubation of
#COVID19
& non-COVID
#ARDS
patients during VV
#ECMO
: should become the new standard? High survival to hospital discharge (85% for both awake groups) reported in this study!
@asaiojournal
2
54
109
ELSO guideline for transport and retrieval of adult & pediatric patients with
#ECMO
support: types, specific considerations, mobile team structure & responsibilities, clinical governance & risk management
Just out, open access
#FOAMcc
on
@asaiojournal
📎
0
51
94
Cardiac arrest & cardiopulmonary resuscitation in pediatric patients with cardiac disease, narrative review including details on
#extracorporeal
life support
#ECLS
& extracorporeal cardiopulmonary
#resuscitation
#ECPR
Free to read
#FOAMcc
#PedsICU
🖇️
2
37
92
Veno-venous extracorporeal support &
#SARSCoV2
#Coronavirus
induced
#ARDS
infection are both potentially associated w changes in hematological and biochemical parameters: here open access narrative review
#COVID19
#FOAMcc
#FOAMecmo
#COVIDFOAM
@Crit_Care
0
55
87
Volume status & outcome on VV
#ECMO
: VV ECMO survivors had a significantly more negative CFB during the first 7 days of veno-venous
#ECLS
, and cumulative fluid balance identified independent predictor of 90 day mortality in this
@asaiojournal
study.
2
41
82
Hannah Cheriyan was born with her umbilical cord wrapped around her neck. Close to asphyxiation, she was airlifted to U-M's C.S. Mott Children's Hospital & placed on
#ECMO
. in the
#ECLS
team our Dr Bartlett: today, he handed Hannah her diploma as she graduated with her M.D./Ph.D.
Decades ago, U-M's Dr. Robert Bartlett was on the life-saving team when Hannah Abraham was born and went into severe respiratory distress. Today, he handed Hannah her diploma as she graduated with her M.D./Ph.D.
#UMichMSTP
#GoBlueMed
37
414
4K
0
15
79
🩸 Heparin vs Bivalirudin for anticoagulation in adults on
#ECMO
, systematic review/meta-analysis: bivalirudin? fewer overall + circuit-related thrombotic events, No differences in major bleeding. Higher survival for bivalirudin recipients
@asaiojournal
📖
1
44
79
Successful development & implementation of intensivist-led
#ECMO
program providing VA VV &
#ECPR
. This strategy might be an option particularly for hospitals with limited access to surgical subspecialists seeking to develop robust program
@asaiojournal
🗞️
2
30
77
The new
@SCCM
&
@ESICM
guidelines for managing pediatric pts with septic shock and sepsis associated organ dysfunction: full text open access on
@PedCritCareMed
Executive summary
@yourICM
0
51
75
Arterial pH at cannulation in VA
#ECMO
? Strong correlation between pH <7 & lactate >7 & reduced survival in this study. Survival possible even with extremely low pH, but rare:
#ECLS
should be considered with caution.
@asaiojournal
🖇️
1
22
76
#COVID19
patients that received prolonged noninvasive respiratory support (HFNc included) before
#ECLS
(≥3 days) significantly less likely to be weaned from ECMO (approximately 50% reduction in liberation rate) or discharged from hospital
@asaiojournal
📎
0
36
75
Discussion on indications for VA ECMO in CS, pt management during run, weaning criteria & exit strategies ongoing on
@asaiojournal
!!
📎
📎 Reply to
Referred to
@ELSOOrg
guidelines for VA
#ECMO
in adults
📎
0
32
73
Femoral venous self-expanding
#ECMO
drainage cannula: diameter can be reduced at insertion, then maximized, resulting in large catheter. In this early experience including 6 pts device appear safe/easy to insert, eventually percutaneously.
@asaiojournal
1
29
72
Right ventricle on VV
#ECMO
➡️ right ventricular Injury in
#ARDS
➡️ does VV
#ECLS
unload injured RV?
➡️ mechanisms of RV injury on veno-venous support
➡️ RV support & mitigation of further injury
➡️ veno-pulmonary arterial configuration
@asaiojournal
1
28
68
The
@ELSOOrg
- Extracorporeal Life Support Organization 2020 guideline for prolonged extracorporeal life support
#ECLS
& extracorporeal membrane oxygenation
#ECMO
for pediatric respiratory failure:
@asaiojournal
#onlinefirst
#FOAMcc
#FOAMecmo
0
38
66
Bivalirudin in patients with refractory cardiogenic shock on VA
#ECMO
: in this large study appears beneficial compared to unfractionated heparin, due to reduction in thrombosis & bleedings, with improved survival to decannulation.
@asaiojournal
📎
1
26
64
Acute cardiac injury related to myocardial localization of
#SARSCoV2
#Coronavirus
in a patient with
#COVID19
presenting with respiratory distress, hypotension & cardiogenic shock successfully supported with venous‐arterial
#ECMO
and mechanical ventilation
0
39
65
Systematic review investigating outcomes on
#ECMO
without systemic anticoagulation suggesting comparable rates of circuit/pt thrombosis regardless of anticoagulation.
PS adhere to
@ELSOOrg
guidelines & report thrombotic/bleeding complications
@asaiojournal
0
39
65
Human factors in
#ECLS
, narrative review:
🔹ECLS as a team approach
🔹
#ECMO
team? requires leader
🔹skills of ECLS team leader
🔹safety briefings & error reporting
🔹reducing errors/mistakes
🔹mental practice/training
🔹role of
#simulation
training
🔹costs
3
24
65
Percutaneous PA cannulation to manage acute secondary right heart failure on VV
#ECMO
: large series describing conversion from veno-venous to veno-pulmonary artery return, providing both RV and respiratory support, with flows up to 6 LPM.
@asaiojournal
0
29
64
Monitoring during
#ECMO
support: novel applications of existing monitoring modalities alongside evolving technological advances enable advanced monitoring required for safe delivery of ECLS.
@CO_CriticalCare
0
31
63
Multicentric study investigating ECCO2r + RRT in
#COVID19
pts with
#ARDS
with AKI when conventional settings failed to obtain protective MV. Combination able to ensure ultraprotective MV maintaining constant PaCO2/pH & providing effective RRT
@asaiojournal
0
27
61
Veno-venous
#ECMO
in
#COVID19
: report of successful short run in a case of severe respiratory failure and signs of hyperinflammation (including marked elevation of C-reactive protein & Interleukin-6) and acute renal failure open access on
@asaiojournal
0
30
60
🍄 Fungal infections common on
#ECLS
: here results of ex-vivo study to determine percentage of sequestration of caspofungin, posaconazole, voriconazole. Therapeutic concentrations cannot be guaranteed with standard dose in this population.
@asaiojournal
🖇
4
22
62
Novel LV unloading strategies on peripheral VA
#ECMO
support: LAVA & PAVA
#ECLS
effective in LV unloading, with trend favouring outcomes & improved probability of survival in this small cohort. PA cannulation appeared quick/inexpensive.
@asaiojournal
🔓
Alternative LV unloading strategies on peripheral VA
#ECMO
🌋 LAVA direct left atrial veno-arterial LAVA cannulation
🫁 PAVA pulmonary artery veno-arterial venting
vs
#Impella
& IABP as bridge to
#transplant
#LVAD
or myocardial recovery.
@asaiojournal
🔓
0
32
83
1
23
61
The
@MayoClinic
experience, reporting a 60% survival rate in a population of 25 patients initiated on
#ECMO
support in the cardiac catheterization laboratory, despite an extremely high predicted mortality (73%) based on the Apache IV score.
1
32
61
We increasingly push the boundaries with
#ECMO
... A bridge to nowhere means that we know, with no uncertainty, that pt will not survive hospitalization. How do we minimize not just physical pain, but also emotional suffering?
@nytimes
@danielalamasmd
🗞️
0
25
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#ELSO2022
is over: thanks to attendees, speakers, exhibitors, organizers, technicians... who contributed. Last on stage, chat with Dr Bartlett, handover between Presidents & closing remarks by our CEO. Let's invite you for
#ELSO2023
, in Seattle, WA
@GraemeMacLaren
@FOAMecmo
0
9
59
Blood changes in VV
#ECMO
systems: development & validation of equilibrium model to understand interrelated, physicochemical mechanisms leading to pH/electrolyte distribution changes due to extracorporeal oxygenation/CO2 removal.
@asaiojournal
0
20
59
Trending topic
The
@WHO
is distributing an Interim Guidance for Clinical management of severe acute respiratory infection when nCoV is suspected including a statement related to
#ECMO
support; A comment by the
@ELSOOrg
President
@OginoMark
on our FB page
1
44
59
The
#ECMO
council: multidisciplinary selection committee utilizing consensus + standardized process to support
#ECMO
pts selection.
Frequent reasons for decline included multiple relative contraindications, age >60y, resource limitations.
@asaiojournal
📎
0
25
58
#Extracorporeal
blood flow on VV
#ECMO
: proposal of a strategy involving daily assessments of native lung function & protocol driven daily optimisation of BF, followed by optimisation of sweep gas flow rate & oxygen fraction in the sweep gas flow
#FOAMecmo
0
22
55
Pediatric extracorporeal cardiopulmonary
#resuscitation
@ELSOOrg
guidelines:
🔹 what is
#ECPR
?
🔹 why consider ECPR for cardiopulmonary Arrest in children?
🔹 ECPR outcomes & ELSO Registry
🔹key elements to improve
Just published open access
@asaiojournal
0
32
58
Bivalirudin vs heparin based anticoagulation strategy: data from largest cohort (to date) of pediatric cardiac patients on
#ECMO
. Heparin may increase need for PRBC transfusions and strategies to attenuate bleeding, compared with bivalirudin.
@asaiojournal
0
28
56
Anti-Xa & aPTT monitoring in adults on
#ECMO
support: inIn this evaluation, anti-Xa assay better correlated with weight based dose vs aPTT; low anti-Xa values predictive of thrombosis & high aPTT predictive of bleeding
@asaiojournal
1
35
56
#CRRT
on veno-venous
#ECMO
: reduced rate of renal replacement therapy circuit clotting adding regional citrate anticoagulation vs sole systemic heparin anticoagulation during
#ECLS
observed in this retrospective study
#onlinefirst
@asaiojournal
2
28
57
Anticoagulation in VV
#ECMO
: study including 123 pts stratified into 3 eras of anticoagulation strategies:
ACT 160–180''
high-PTT 60–80''
low-PTT 45–55''
L-PTT? Major bleedings significantly lower; no difference reported in thrombotic events
@asaiojournal
0
22
56
Membrane Lung dysfunction on
#ECMO
: hematologic abnormalities, mechanical obstruction, inadequate gas exchange underlie most of scenarios requiring ML exchange.
Must-read editorial outlining a physiologic approach to troubleshooting. Open access
@Crit_Care
0
16
55
The
#ELSORegistry
has officially achieved the 100,000 patient! Congratulations, Dr Bartlett for your visionary work. Thank you
#ELSO
centers for submitting data to allow the creation of a database which helps improve the care and outcome of
#ECLS
pts
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