Description
Extracorporeal Membrane Oxygenation (ECMO) plays a pivotal role in critical care, providing advanced life support for patients with severe cardiac or respiratory failure. By temporarily assuming the function of the heart and lungs, ECMO allows vital organs to recover, offering a crucial bridge to recovery or transplant. Its capacity to maintain oxygenation and circulation in critically ill patients underscores ECMO's significance as a lifesaving intervention in the intensive care setting.
Résumé
- Dr. Audu Gonuguntla presented a webinar on the role of Extracorporeal Membrane Oxygenation (ECMO) in critical care, highlighting its use in ICU settings, particularly after a surge in demand during the COVID-19 pandemic for severe ARDS management. ECMO serves as an extension of the cardiopulmonary bypass machine, providing prolonged support to patients with respiratory and cardiac failure.
- The presentation outlined the physiological basis of ECMO, comparing it with traditional treatment options like mechanical ventilators and intra-aortic balloon pumps. Respiratory failures were classified into four types, with indications for ECMO being cardiogenic shock (with or without myocardial infarction), pulmonary hypertension, and hemodynamic compromise. Veno-arterial (VA) ECMO is favored when the heart is significantly compromised, while veno-venous (VV) ECMO is used for severe lung dysfunction with a functional heart.
- Several scoring systems, including the Murray score, RESP score, and SAVE score, were discussed as tools to assess patient suitability and predict survival outcomes with ECMO. The importance of considering factors such as patient age, immune status, pre-ECMO ventilation duration, diagnosis, and neurological function was emphasized. This assessment guides clinical decision-making, family counseling, and preparation for ECMO implementation.
- The various types of ECMO support were also addressed, detailing the differences between veno-venous, veno-arterial, and extra-corporeal CO2 removal. Specific attention was given to veno-venous ECMO, contrasting the two-cannula and single-cannula approaches, focusing on blood flow rates, gas exchange efficiency, and sweep gas flow.
- A real-life case study was presented to illustrate the practical application of ECMO, detailing the management of a 65-year-old diabetic patient with severe ARDS. The presentation highlighted the multidisciplinary preparation needed for ECMO implementation and troubleshooting potential complications, including recirculation, cannula site infections, and broncho-pleural fistulas.
Exemple de certificat
À propos des intervenants
Dr Atchyuth R Gongada
Chef de service et consultant principal, département de soins intensifs et d'anesthésiologie, hôpitaux Apollo, Healtcity, Visakhapatnam
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