Everything ECMO

In specialist centres, extracorporeal membrane oxygenation (ECMO) is a now a mainstay of the management of cardio/respiratory failure refractory to other measures. However, much of the clinical information required to care for ECMO patients at the bedside remains inaccessible to learners. To address this, the creation of a free-to-access educational ECMO blog post is now a requirement for completion of the Alfred ICU ECMO Accreditation Certificate.

“Everything ECMO” blog posts are created by ICU Senior Registrars, Fellows, and Consultants and are peer-reviewed by one or more ECMO specialists from the Alfred ICU.

This has culminated in a high quality, peer-reviewed collection of resources for learning ECMO using a fictionalized case-based Q&A format. Indeed, the blog that curates the series, INTENSIVE, was recently assessed as among the “top ten” critical care educational websites in the world using the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET) (Wolbrink et al, 2018).

Everything ECMO Posts

• 001 — Persistent hypoxaemia on VV ECMO
• 002 — VV ECMO ventilation and weaning
• 003 — An ECMO earthquake? (access insufficiency)
• 004 — Why is the bag turning red? (haemolysis)
• 005 — Cardiac arrest on VV ECMO
• 006 — Access insufficiency is just the beginning… (complications of VV ECMO and necrotizing pneumonia)
• 007 — What is different about hypoxia on VA ECMO? (differential hypoxia aka Harlequin Syndrome)
• 008 — Weaning from VA ECMO
• 009 — Differential hypoxia in reverse?! (pseudo-differential hypoxia and reverse differential hypoxia)
• 010 — Keep calm and cannulate! (ECMO cannulation)
• 011 — Go with the flow (High-flow VV ECMO configuration)
• 012 — Turn and face the circuit… ch-ch-change it! (ECMO circuit change)
• 013 — Pump it! (Ventricular Assist Device (VAD) concepts)
• 014 — Not just little adults… ECMO and paediatric lung transplantation
• 015 — Cardiac arrest on ECMO… Does it still count? (ECMO cardiac arrest)
• 016 — Holy HITTS! (Oxygenator thrombosis, HITTS)
• 017 — ECMO Circuit Rupture!
• 018 — ECMO Cannula Rupture!
• 019 — Bad bubbles and VV-ECMO (Air embolus on VV ECMO)
• 020 — “Pink fluid coming up the tube”.. ECMO, LV distention, and more!

For an updated list, and numerous other ECMO resources, visit the ECMO page on INTENSIVE.

References and Links

LITFL

• CCC – Everything ECMO
• CCC – ECMO troubleshooting
• CCC – Pharmacokinetics and ECMO
• CCC – Own the ECMO (presentation by Hergen Buescher, 2011)

Journals

• Wolbrink TA, Rubin L, Burns JP, Markovitz B. The Top Ten Websites in Critical Care Medicine Education Today. J Intensive Care Med. 2018;:885066618759287. [PMID 29519206]

Disclaimer: I am an intensivist and ECMO specialist at the Alfred ICU, and editor and co-creator of INTENSIVE and the “Everything ECMO” series.