For patients with acute hypoxemic respiratory failure, whether high-flow oxygen is superior to standard oxygen in reducing mortality is unclear. Research findings from the SOHO trial are summarized in a new Quick Take video. nej.md/4x706JY

RT @EuroELSO: 📢 When RV fails: recognition and #ECLS strategies across critical illness, #EuroELSOwebinar 🫁The failing RV in severe respira…

Final reminder, if you haven't already done it, can you please help those group of researchers by filling there survey? Thank you docs.google.com/forms/d/e/1F…

Interesting trial result, ahead of ANDROMEDA-SHOCK 2 in a fortnight Targeted Tissue Perfusion vs Macrocirculatory-Guided Standard Care in Patients With Septic Shock: - The TARTARE-2S RCT CCR Journal Watch criticalcarereviews.com/late…

British societies guideline on management of emergencies in patients on ECMO 🫀Recognition of cardiac arrest 🏥 Team structure 🕵️ Early troubleshooting @BritishCardioSo @FICMNews @ICS_updates @BACCNUK @SCTSUK @BSHeartFailure @ResusCouncilUK @ACTACCUK link.springer.com/article/10…

📣Our new PRORVnet collaborative publication (CCR) is out in AJRCCM 🫁🫀   'RV Hemodynamics in ARDS: Monitoring and Implications for Clinical Management'   @ATSBlueEditor, #Douglas Slobod, @drhaty, @MadsDam_MD, @DenaultAndre, @prorvnet  atsjournals.org/doi/abs/10.1…

Long-term outcomes after VA #ECMO in adults 🔍 multicenter @anzics study investigating incidence of death or new disability at 12 months after VA #ECLS initiation in 🇦🇺 & 🇳🇿 At 12 months 30% pts alive without new disability. Major burden of disability appears to develop in first 6 months ⚖️ different outcome associated with reason for ECLS ⚖️ at 12 months (vs 6) more pts independent in AdL (62.1% vs 48.2%), fewer unemployed due to health reasons (32.7% vs 47.4%) 🖇️ bit.ly/3Sxl5m0

Anticoagulation in #ECMO: how to reduce bleedings? 🔍prospective cohort study including 277 adults on #ECLS 🩸risk of hemorrhagic events 2.97-fold higher in patients with a PTT > 70 vs patients under no UFH therapy Association observed between target PTT & hemorrhagic complications, with risk higher when maintaining PTT values greater than 70". Lower PTT targets may reduce hemorrhages without increasing risk of thrombotic complications. @asaiojournal #FOAMcc #FOAMecmo 🔓 bit.ly/4hlO2vj

Veno-pulmonary #ECLS? carefully managed to avoid negative hemodynamic impact! 🩸elevated EBF increase mPAP/LAP & reduce PA pulsatility potentially leading to complications such pulmonary hemorrhage permanent vasculature damage: hemodynamic response should be considered when selecting or titrating EBF 🫁🫀effect vary significantly depending on RV function. Consider RV injury severity & corresponding afterload, to maintain stability prevent lung complications. @asaiojournal 🖇️ bit.ly/41VMnrP

Initiation of #ECPR in patients presenting with out-of-hospital cardiac arrest? Emergent mechanical circulatory support with VA #ECLS offers a bridge to diagnostic & therapeutic interventions, but can be challenging to provide in a timely fashion. 🔍 55 OHCA patients received ECPR after presenting to ED of large 🇺🇸 academic medical center with active #MCS cardiac #transplantation program 🗓️ May 2013 to December 2022 🏥 increase in survival to hospital discharge from 22% to 52% 🧠 69% of those discharged had favourable neurologic function (CPC 1-2) Organizing & implementing a multidisciplinary dedicated #ECMO response team & ECPR program for OHCA, coordinating institutional resources, may improve survival increase number of runs in OHCA patients. 🔗 bit.ly/4hhmirv

Non-invasive positive pressure ventilation - BiPAP and CPAP, for example - can be a bit of a black box to most of us ⬛️ Once it's started, the nuances of how to adjust it to optimize each patient's physiology takes skill. In the wise words of @iceman_ex - "The goal is to titrate PEEP to the triad of best compliance, best oxygenation, and best RV function" 🫁🫀

Lung injury in myocardial infarction-associated cardiogenic shock supported by venoarterial extracorporeal membrane oxygenation: a scoping review link.springer.com/article/10…

Exciting opportunity alert! 🌟 Join us in Manchester on April 24&25, 2025, for the 14th Ultrasound in Acute Care event. Learn basic to intermediate US techniques from leading pioneers in the field. @iceman_ex @icmteaching @Assoc_Anaes @FICMNews @RCollEM @IM_Crit_ @RCollEM @CC_3N

Right ventricular Injury in patients with in respiratory failure receiving VV #ECMO 🔍 scoping review aimed to map current literature & guide research on definition & management 📚 30 studies reported on RVI (dilation, dysfunction, failure) 📚 23 studies reported on (heterogeneous) definition, including #echocardiographic indices of RV function/dimensions 📚 13 studies reported on management, including VP & VA ECMO, positive inotropes, pulmonary vasodilators, ultra-lung-protective MV, PEEP optimization Despite high incidence & strong association with mortality, review highlights scarcity/heterogeneity in studies investigating modalities, criteria for diagnosis, therapeutic strategies for RVI during during VV #ECLS @asaiojournal 🔗 bit.ly/4fT9MxG 📚 Review informed Delphi study by PRORVnet study providing related expert position statements #FOAMcc on @yourICM 🔓 rdcu.be/dP6Kz

💉 Sedation practices in adult patients with severe #ARDS on extracorporeal respiratory support using VV #ECMO: if you are an ECMO physician provider don't miss the opportunity to join this survey! 🔗 bit.ly/4fP4oM4 ⏱️ takes 9' to complete. 🗓️ deadline: January 21, 2025.

If you need a refresher on Swan-Ganz catheters and PA pressures, this is good. Actually, I am lying. It is VERY good... Thank you Matt, Sergio, Max et al!

Development of novel VA #ECMO drainage cannula ⚙️ fluid dynamics #simulation 🔍 ex vivo evaluation 🩸hemolysis assay 🩸PLT activation & receptor shedding 🩸degradation of vW factor multimers 🩸clot volume analysis within cannulae @asaiojournal 🔗 bit.ly/4a4zpKJ

Use of extracorporeal blood purification therapies in #sepsis/septic shock 🧫 rationale & available clinical evidence supporting use of: #RRT, plasma exchange & coupled plasma filtration adsorption, hemoadsorption 🩺 considerations for current clinical practice 🔍 (future) research: heterogeneity of populations & therapies dosing/timing, endpoints Integration of additional therapies within treatment protocols can optimize care/improve outcomes, but these must be applied at correct time/dose, taking into account their impact on drugs (eg ABTs). Era of “one size fits all” is over: time has come for paradigm shift toward more focused/personalized approaches in clinical practice/research. Open access #FOAMcc on @Crit_Care 🔓 rdcu.be/d422p

Permissive hypercapnia in acute severe respiratory failure: should we target PaCO2, pH or both?? Safe thresholds in critically ill? 🩺mechanisms & management of hypercapnia requiring IMV 🫁 impact of hypercapnia on outcomes 🫁 🫀🧠significant physiological effects: RV & pulmonary circulation, brain & other organs Hypercapnic acidemia during lung-protective MV may have significant consequences, and perhaps should not be a goal per se, but prompt early consideration of adjunctive therapies. Open access #FOAMcc 🔓 bit.ly/49TxOY8

Modified CALS including rescue-focused cardiac ultrasound and early institution of extracorporeal cardiopulmonary resuscitation instead of chest reopening.#ECMO #CALS #Cardiacarrest jcvaonline.com/article/S1053…