TA #NRP in cDCD heart donors using closed #ECMO circuit, modified to provide 🩸🌡️effective NRP despite prolonged fWIT 🫀LV venting 🫀 fast conversion to central configuration as needed ⭕️ shunt for recirculation 🫧 air management #FOAMcc @asaiojournal 🔓bit.ly/TANRPasaio TA-NRP using fully mobile, closed #ECLS circuit could be safe strategy to support combined thoracic/abdominal organs recovery also in peripheral centers without cardiac surgery program, contributing to the expansion of DCD programs, increasing availability/quality of grafts, improving recipients’ outcome. @ESOTtransplant @gabriel_oniscu @LuPoten @Unibo @AUSLRomagna

Mechanical ventilation during VA #ECMO, systematic review aimed to summarize & describe studies investigating effects of MV settings and adjunctive respiratory interventions on hemodynamics, cardiac recovery, clinical outcomes. 📖 MV cornerstone for patients in #ECLS, but available evidence is sparse/low quality, highly heterogeneous, and at considerable risk of bias, preventing any reliable inferences. #FOAMcc #FOAMecmo @Crit_Care 🔓 rdcu.be/fnfsg

📘 Donation after Circulatory Death #DCD liver transplantation and machine perfusion: a practical guide is out! Book explores in depth the use of normothermic/hypothermic machine perfusion, NRP, and how they can be leveraged to improve availability, safety and outcomes of DCDD liver grafts. 📖 bit.ly/DCDLiverTx Pleased of being invited to be author of NRP circuit and perfusion chapter: ⚙️ extracorporeal circuit 🩸 pump, driving unit, blood flow 💨 membrane lung, oxygenation, CO2 removal 🩸 venous reservoir 🩸 anticoagulation 🚧 NRP complications and troubleshooting Link to the chapter: 📖 bit.ly/DCDLiverNRP

🚨 #ECMOBARNA2026 is here! 🚨 🏆 ELSO Endorsed Course (2 Step ELSO E-AEC) 🌍 NEW: Two dedicated English-speaking groups 🫀 Hands-on #ECLS workshops 🎮 Hybrids VITA ECMO simulation 🐷 Animal lab training ⚠️ Limited places! 🌐 ecmobarcelona.org

#ECMO before pediatric heart #transplantation: comparing two eras 🔍 >1K #ECLS supported children from UNOS Database included: 58% in era 1 (2005–14), 42% in era 2 (2015-24) 🫀 52% transplanted, 56% in era 1, 44% in era 2 🪦 total waitlist mortality 34.9%; patients in era 2 demonstrated significantly higher survival Although use of ECMO before #Tx decreased over the years, survival and outcomes significantly improved. Compared to previous decade, ECMO is associated with lower waitlist mortality and improved long-term survival. #PedsICU @asaiojournal 🔗 bit.ly/4fwcVHp

Establishing standards for controlled Donation after Circulatory Determination of Death in adults: the Bucharest international @ESOTtransplant consensus 🛠️ system requirements for cDCDD programs 📋 preserving & 🔍 identifying opportunities for cDCDD 🩺 assessment of medical suitability 🫴🏻 communication about donation 🕯️managing WLSM & end-of-life care process ⚖️ use of ante-mortem interventions #FOAMcc 🔓 bit.ly/4vvLkL9

Development and internal validation of perioperative bedside risk score to assess #ECLS need after Norwood in #PedICU: 🔍 322 neonates (2010-2023) 🫀 22% postoperative #ECMO 🩺 6 independent predictors: moderate-severe atrioventricular valve regurgitation, modified BTT shunt, CPB duration >173.5', VIS > 19.5 on ICU arrival, delayed sternal closure, postop iNO use ⚖️ score stratified pts into low, moderate, high-risk, with corresponding ECLS rates of 8%, 31%, 65% This novel risk tool demonstrated good discrimination, and may support early clinical decision-making and triage in high-risk neonates. @asaiojournal 🖇️ bit.ly/4e5tgR6

🫀Left Ventricular venting in children with myocarditis requiring VA #ECMO?? Case series describing percutaneous LV venting technique in 3 pediatric patients with fulminant myocarditis using pigtail catheter retrogradely inserted into LV. Effective unloading achieved in all patients, allowing successful weaning from #ECLS. One patient developed limb ischemia requiring DPC; no additional catheter-related complications occurred. This approach appears to be a feasible and less invasive option, providing technical simplicity and reducing surgical burden and bleeding risk. @asaiojournal 🖇️ bit.ly/4o75MzI

Kinetics of sevoflurane vaporized directly in #ECMO membrane lung  🔬ex-vivo trials using circuits primed with Ringer’s lactate; sevoflurane vaporized at concentrations of 1–8% with SGF of 1–10 L/min.  💨 sevoflurane effectively crossed PMP membranes, rapidly reaching reproducible peak concentrations to values consistent with clinical targets for deep sedation; clearance increased significantly with higher SGF  ⚠️ environmental concentrations well below occupational safety thresholds  Delivering sevoflurane vaporized directly into ECMO circuits feasible/safe alternative sedative strategy. These results provide a robust foundation for translating this into pilot clinical trial aimed at optimizing ECMO sedation with inhaled sevoflurane in patients with severe ARDS. 🔓 rdcu.be/fk2xq

ExtracorporeaL life support and Modification Of Hemostasis, ELMOH trial: 🩸early hemostatic profiles differed markedly between #ECMO for circulatory vs isolated respiratory failure 🫀 VA patients showed lower PLT counts, more hypocoagulable profile, higher bleeding incidence early after initiation, partially improved within 48 h 🫁 VV showed stable and relatively hypercoagulable profile Close individualized hemostatic monitoring and anticoagulation management pivotal to optimize outcomes in this high-risk population. #FOAMcc #FOAMecmo @Crit_Care 🔓 rdcu.be/fkyDT

FLIGHT-to-ECPR study: Helicopter-EMS-facilitated hospital-based #ECPR to expand access to #ECMO in CA?? Low-flow times frequently extended in rural settings! 🚁 45 adults with refractory VF/VT OHCA 🩸 60% ECPR, low-flow = 86'±29 🧠 overall favourable neurologic survival 33%: 26% in ECPR, 44% if no cannulation In matched ECPR patients, similar low-flow times, same favourable survival. No differences in cannulation performance, run duration, LoS. HEMS-facilitated strategy feasible & safe to expand access to advanced resuscitation beyond traditional urban areas. Geography alone should not preclude ECPR when timely reperfusion can be maintained. @ResusJournal 🔓 bit.ly/3PAaOI4

🫁 Awake #ECMO cannulation, with sedation and a natural airway, before intubation in children, to provide hemodynamic stability gas exchange to mitigate the risk of cardiopulmonary arrest during induction of anesthesia and intubation? Feasible in in high risk pediatric patients with varied physiology and rationale for #ECLS before (or in lieu of) intubation, with appropriate preparation and expertise. @asaiojournal 🖇️ bit.ly/4eXZY99

Impaired cerebral autoregulation in pediatric patients in #ECMO: 🔍 observational study aimed to measure CAR in different phases of #ECLS and analyze association with radiographic neurologic injury 🔎 72 children (0–18 y) with no prior neurologic injury, CPB, ECMO, or CHD who underwent brain imaging included 🧠 severe neurologic injury 12.5% ☢️ no association between overall time with impaired CAR and neurological injury on head imaging ⚖️ impaired CAR burden significantly higher pre-ECMO vs peri-cannulation and on-ECMO time periods; significant association between pre-ECMO hypotension during impaired CAR and neurologic injury score #FOAMcc #FOAMecmo #PedsICU @NeurocritCareJ 🔓 rdcu.be/fjA27

Organ donation after #ECPR, narrative review aimed to examine associated clinical & ethical challenges, with particular attention to transition from resuscitative intent to donation-oriented care ⚠️ patient autonomy 📋 consent ⛔️ conflicts of interest ⚖️ equity of access in adults & peds @Crit_Care 🔓 rdcu.be/fjpEl

(1/10): We are pleased to announce the launch of ISOPPT,the International Society for Organ Preservation and Perfusion Therapy. Our society brings together medical professionals, researchers, industry leaders, engineers, and educators from around the world with the shared mission

RT @EuroELSO: ⏰DON'T miss #EuroELSOwebinar: #ECMO in Hantavirus cardiopulmonary syndrome. An opportunity to discuss pathophysiology, diagno…

#ECMO without invasive mechanical ventilation for #ARDS?? 🔍 307 adults, at 14 centers in 8 countries (2015-2024) 🫁 113 primary awake ECMO = treated to avoid IMV 🫁 194 extubated ECMO They presented different baseline characteristics, strategy failure, 90-day mortality, 30.1% in the primary awake ECMO group and 14.9% in the extubated ECMO ⚖️ respectively: strategy failure 40.7% and 24.2%, associated with mortality in both groups. The leading cause of strategy failure was worsening of respiratory failure, followed by agitation/delirium in primary awake ECMO and inability to clear secretions in extubated ECMO. 🔗 bit.ly/4dvDl9G

Early bedside colonoscopy for detection of colon ischemia after #ECPR: any role in routine clinical management? Reliance on clinical signs, laboratory parameters, or CTA alone may delay diagnosis or miss early ischemic lesions in this population. 🔍 83 patients without evidence of mesenteric ischemia prior to #ECMO surviving > 24 h 🖥️ colonoscopy performed in #ICU within 72 h after collapse: GI ischemia >40% = major, clinically relevant complication 🚑 significantly more frequent after OHCA vs IHCA ⏱️ every additional minute of impaired circulation associated with increased risk 🩺 pathophysiological mechanisms underlying early intestinal injury after ECPR remain incompletely understood: hypo-perfusion during CPR, IRI, #ECLS hyper-oxygenated blood, or a combination of these?? Early bedside colonoscopy feasible and safe, providing diagnostic information that directly influenced further management, including surgical intervention in selected patients. Open access #FOAMcc #FOAMecmo 🔓 rdcu.be/fiycX

RT @ELSOOrg: 🫘 Extracorporeal membrane oxygenation, acute kidney injury, fluid balance, and continuous renal replacement therapy: Acute Dis…

ECMO, acute kidney injury, fluid balance, and continuous renal replacement therapy: 🫘 epidemiology, risk factors, outcomes of #AKI & #CRRT 💦 fluid management and outcomes 📋 indications for CRRT and fluid removal during #ECMO, and best practices for performing 💉 biomarkers, extracorporeal blood purification, drug PK/PD ADQI and @ELSOOrg joint consensus conference, aimed at providing recommendations, identifying knowledge gaps and research priorities based on international expert consensus, to serve to lay the foundation for a standardized approach across #ECLS centers #FOAMcc #FOAMecmo @yourICM 🔓 rdcu.be/fh662