VA ECMO in Refractory Septic Shock, Part 1

Mar 31, 2025

Delve into the world of VA ECMO for children facing refractory septic shock. Hear expert insights on timely interventions and the complexities of patient management. Discover critical indicators for selecting candidates for ECMO and the importance of hemodynamic assessments. The discussion highlights the balance between flow rates and outcomes, along with approaches to optimize care. Personal stories enrich the exploration of mentorship and innovation in pediatric critical care, emphasizing collaboration for better patient outcomes.

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Intro

00:00 • 6min

VA ECMO in Pediatric Septic Shock

05:34 • 13min

Evaluating ECMO Indications in Pediatric Septic Shock

18:39 • 3min

Understanding ECMO in Refractory Septic Shock: Navigating Hemodynamics

21:22 • 3min

Optimizing VECMO Flows in Refractory Septic Shock

24:40 • 5min

Thanks to Dr. Abhinav Totapally who is a pediatric intensivist at Nicklaus Children's Hospital in Miami and Dr. Brian Bridges, the Division Chief of Pediatric Critical Care Medicine at the Medical University of South Carolina in Charleston for joining us for this series.

Check out their paper published in PCCM in January 2025

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

The rationale supporting and the limitations of using VA ECMO for children with refractory septic shock.
Patient selection in the use of VA ECMO for children with refractory septic shock.
The benefits and risks of common cannulation strategies for VA ECMO in children with refractory septic shock.
An expert approach to supporting children with refractory septic shock on VA ECMO.

Reference:

Totapally A, Stark R, Danko M, Chen H, Altheimer A, Hardison D, Malone MP, Zivick E, Bridges B. Central or Peripheral Venoarterial Extracorporeal Membrane Oxygenation for Pediatric Sepsis: Outcomes Comparison in the Extracorporeal Life Support Organization Dataset, 2000-2021. Pediatr Crit Care Med. 2025 Jan 23.

Citation: Totapally A, Bridges B, Shanklin A, Hodges Z. VA ECMO in Refractory Septic Shock. PedsCrit. Online Podcast. 03/2025. https://www.pedscrit.com/va-ecmo-in-refractory-septic-shock-part-1/

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

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Thank you for listening to this episode of PedsCrit. Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at pedscritpodcast@gmail.com. Check out http://www.pedscrit.com for detailed show notes. And visit @critpeds on twitter and @pedscrit on instagram for real time show updates.