VV ECMO Part 4: Extubation, decannulation, and long-term effects

May 15, 2023

Guest Jenna Miller, MD, discusses the key milestones for extubation on VV-ECMO, mobilization practices for different age groups, and long-term neurologic effects. Also covered are the weaning and decannulation process, procedural sedation, and the importance of collaboration in VV-ECMO.

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Introduction

00:00 • 3min

Mobilization and Rehabilitation on ECMO in the PICU

03:06 • 16min

Weaning and Decannulation Process on VV ECMO

18:53 • 3min

Procedural Sedation and Neurodevelopmental Outcomes in ECMO Patients

22:20 • 6min

Sharing Experiences and Emphasizing Collaboration in VV ECMO

27:52 • 2min

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children’s Mercy Kansas City.

Learning Objectives:

After listening to this episode, learners should be able to:

The Identify key networking opportunities within the ECMO world.
Understand the risks and benefits of VV-ECMO cannulation.
Discuss common and newer indications for VV-ECMO cannulation in neonates and school-aged children.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation.
Gurnani et al. Outcomes of Extubated COVID and Non-COVID Pat

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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.