Ecmo

basics of ecmo

1. ECMO (extracorporeal membrane oxygenation)-boon to intensivism Dr imran Gafoor Senior consultant Deptt of intensive care medicine Ramkrishna care hospital,Raipur CG feb 2019

2. ARDS is a syndrome rather than disease There is no disease modifying drug therapy for ARDS

3. For over three decades we have been struggling to change outcomes in ARDS patients

4. Physiological rationale for ECMO ECMO effectively maintains adequate gas exchange , replacing respiratory function,through an artificial lung ,thereby unloading respiratory system,allowing recovery . ELSO RED book 2017

5. ECMO is a TEAM work

6. ECMO – last resort therapy

7. Veno -venous ECMO circuit

8. Veno – arterial ECMO circuit

9. Veno -venous ECMO (double lumen cannula)

10. Approaches to veno -venous ECMO

11. Most common veno -venous configuration

12. Most common veno -arterial configuration

13. Components of ECMO set up

14. Components of ECMO set up

15. Mechanism of gas exchange in ECMO

16. Components of ECMO set up

17. Cannulae after placement

18. Factors determining gas exchange

19. ECMO set up

20. Factors deciding ECMO candidacy

21. ELSO RED book 2017

22. 10 situations in which ECMO is likely to fail ICM 2015 Wrong choice of ECMO configuration Chronic respiratory or cardiac disease with no hopes of recovery/transplant Out of hospital ECMO-CPR ≥ 50 mins Severe Aortic regurgitation or type A aortic dissection Refractory septic shock in adults with preserved ejection fraction Allogenic stem cell transplantation Age › 70 yrs with severe ARDS ARDS with multiple organ failure Prolonged pre-ECMO mechanical ventilation (› 7 days) Centres in-experienced in ECMO

23. ECLS registry jan /2019

24. RCT on ECMO

25. Transport with ECMO

26. ambulatory ECMO

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