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RV #POCUS on VV #ECMO?? 🖥️ 60.6% had normal RV function at ECMO initiation 🖥️ 42% had normal RV function at second post-ECMO #POCUS 🫀 worse outcomes if ⬆️ RV dysfunction 🫀 ⬆️ run duration & EBF correlate with progressive RV dilatation/dysfunction, associated with poor survival

🫀🫁Right ventricular injury in adults receiving #ECMO for respiratory support, rationale & expert position statements: PRORVnet study Open access #FOAMcc #FOAMecmo on Intensive Care Medicine 🔓 bit.ly/ECMORVDelphi

#Immunomodulators in #COVID-19 #ECMO: 🫂 #ELSO registry study of 7,181 patients ❌ Steroids a/w mortality, ✅ other immunomodulators without steroids a/w survival 🤔 Selection bias over #pandemic for steroid-resistant patients? #FOAMed annalsofintensivecare.springeropen.com/articles/10.11…

Immunomodulators in #COVID19 pts receiving #ECMO, analysis of ELSO Registry 🔍>7K pts, immunomodulators in >6K 🪦associated with significantly ⬆️ mortality (particularly steroids) + ⬆️🧫 infections ⏱️longer runs if steroids w/wo other immunomodulators 🔓 bit.ly/4dwiiT3

O2 in VA #ECMO EXCEL registry-embedded 🇦🇺 BLENDER 🎯conservative vs liberal O2 strategy 🔍 300 pts 🔎 conservative: similar short & long-term outcomes vs liberal ⚠️ conservative: NO more major hypoxic complications, more protocol deviations 🔓rdcu.be/dRwvq

Interesting study. Explains some of our findings from the ELSO registry!! Kiran Shekar Graeme MacLaren M Velia Antonini Ryan Ruiyang Ling Ryan Barbaro

Acute hypoxemic respiratory failure in #ICU in 🇦🇺🇳🇿: disease burden may be higher than expected! 🪦mortality ⬆️ with ⬇️ P/F, particularly <200: need to reconsider how we stratify AHRF severity? 🪦mortality ⬇️ over time: improvements in critical care? 🔓 bit.ly/3Xrdh8E

🧐 What is the burden of AHRF in ICUs? 🫂 ANZICS APD 2005-2024: 1.5m patients with ABGs 🫁 >50% had AHRF within 24h of ICU admission! 🪦 Mortality ⬆️with worsening P/F ratios, esp <200. ⏲️ Mortality ⬇️ with time, but not unique to AHRF alone... 🔓 bit.ly/3Xrdh8E #FOAMed

I believe that #ECMO is a life-saving temporising intervention. Yet, there are ethical dilemmas when it appears "futile". In The Lancet Respiratory Medicine, Kiran Shekar Ramanathan KR and I envision a future where ECMO can be reliably used as a long-term device. thelancet.com/journals/lanre…

ECMO as a bridge vs destination therapy.... the path ahead. Pros and Cons The Lancet Respiratory Medicine thelancet.com/journals/lanre… thelancet.com/journals/lanre… ELSO M Velia Antonini Ryan Ruiyang Ling Kiran Shekar

🌊 When #ECMO-dependent patients are no longer candidates for destination therapy, should #ECLS be continued indefinitely? It would eventually serve only as a bridge to fatal complication. Complications might prolong suffering and affect quality of life. Beyond ethical

Thanks to Ryan Ruiyang Ling Kiran Shekar Ramanathan KR for this thought provoking commentary on our comment in The Lancet Respiratory Medicine thelancet.com/journals/lanre… Interdisziplinäre Medizinische Intensivtherapie FR ELSO DGIIN e.V. M Velia Antonini EuroELSO

How should we deal with ECMO when transition to recovery or transplant is no longer possible! Let’s discuss! Kiran Shekar Ramanathan KR Ryan Ruiyang Ling Tobias Wengenmayer Dirk Westermann @StaudacherDawid Justyna Swol MD • ECMOdaily Stefan Kluge ECMO_Karagiannidis Interdisziplinäre Medizinische Intensivtherapie FR thelancet.com/journals/lanre…

Here’s to the memory of Dr Robert E Gross and to the ongoing love and abiding affection we have for Dr Robert H Bartlett and Wanda Bartlett, without whom #ECMO and >100,000 patients would likely not exist ELSO M Velia Antonini @AnnichGail youtu.be/4sfPgPIQ49s?si… via YouTube

Presenting 🇦🇺BLENDER ESICM #LIVES2024🔓 rdcu.be/dRwvq. Liberal oxygen easier to do. No adverse effect on outcomes. Will this change your oxygen strategy on VA-ECMO? EXCEL Critical Care Research Group ANZICS ELSO

Check out our publication describing the current landscape and gaps about Right Ventricular Injury Definition and Management in VV ECMO patients: ASAIO Journal journals.lww.com/asaiojournal/a…

How will you measure your life?

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

Long-term outcome of #ECPR vs cCPR in #OHCA 🇦🇺🇳🇿EXCEL 🪦 28% ECPR/12% CCPR OHCA survivors at 12 months ⚖️ ECPR cohort younger, more likely to receive bystander CPR ⏱️ median arrest to ROSC/ECMO time longer in ECPR, 61 vs 6' 🧠 majority of ECPR survivors did not have

What is the impact of #LV #unloading during #ECPR? Target trial emulation using #ELSO registry: 🏥 300 centres, 621 matched pairs ❌ LV unloading NOT a/w survival benefits 💘 More CNS, CVS, and metabolic complications, and longer #ECMO durations! link.springer.com/article/10.118…