Maryland CC Project Badulak – ECMO Indications & Complications
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Nov 18, 2021 Dr. Jenelle Badulak, an emergency physician and intensivist at the University of Washington Medical Center, dives into the world of ECMO, exploring indications and complications. She shares engaging case studies that highlight patient selection. The discussion delves into the physiology of membrane lungs, gas exchange mechanics, and optimal management strategies for ECMO. Badulak also addresses challenges like hypoxemia and hemodynamics, offering practical solutions for troubleshooting and enhancing patient outcomes.
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Assess ECMO Patient Suitability
- Evaluate patient suitability for ECMO by considering BMI, anticoagulation challenges, and overall physical fitness.
- Confirm mental status and organ function before ECMO initiation to improve survival chances.
Use ECMO With Exit Strategy
- Use ECMO as a bridge only for patients with potential recovery or transplant options.
- Avoid ECMO if multi-organ failure is irreversible or if no exit strategy exists.
ECMO Candidacy Criteria
- Consider low P/F ratios and persistent hypercarbia despite maximal medical therapy as criteria for ECMO candidacy.
- Include proning and neuromuscular blockade before deciding on ECMO.