The St.Emlyn’s Podcast

Ep 225 - A deep dive into ECMO with Andy Curry

Nov 9, 2023

Andy Curry, a Consultant Cardiothoracic Intensive Care Consultant at University Hospital Southampton, dives deep into the world of ECMO, or Extra Corporeal Membrane Oxygenation. He sheds light on its historical milestones and real-world applications, emphasizing the therapy's revolutionary potential in critical care. The discussion touches on advancements and the challenges faced in expanding its use, as well as ongoing research efforts to improve patient outcomes. Prepare for an engaging exploration of this fascinating life-support technology!

37:29

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Episode guests

Andy Curry

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Quick takeaways

The historical development of ECMO illustrates its transition from pediatric use to critical adult applications, underscoring its evolving role in contemporary medicine.

Integration of eCPR into established resuscitation protocols shows promise in improving survival rates during cardiac arrests, yet disparities and resource limitations remain prevalent.

Deep dives

Overview of ECMO Development

ECMO, or extracorporeal membrane oxygenation, has evolved significantly over the past decades and is currently positioned as a critical tool for both cardiopulmonary and respiratory support. The initial applications of ECMO primarily focused on neonates with severe respiratory complications, with early procedures conducted under less stringent ethical standards. Andy Curry traces the historical timeline of ECMO from its pediatric applications to adult uses, highlighting a notable case where an abandoned infant became the first survivor of this technology. As the procedure gained traction, it prompted further investigations into its efficacy, ultimately leading to the establishment of international standards and guidelines for its application in various medical scenarios.

Exploring ECMO: Advancements and Challenges in Cardiovascular Support

2min

A Comprehensive Exploration of ECMO: History, Application, and Challenges

35min

One of the benefits of the use of online platforms for meetings is the ability to record and disseminate talks more widely. This is an edited version of a talk given by Dr Andy Curry, Consultant Cardiothoracic Intensive Care Consultant at University Hospital Southampton, covering the origins of Extra Corporeal Membrane Oxygenation (ECMO) right up to the present day. Throughout the talk, he gives real world experience, coupled with a knowledge of the literature to communicate all you could ever want to know about this fascinating and potentially very exciting therapy.

References

Peek GJ, Clemens F, Elbourne D, Firmin R, Hardy P, Hibbert C, Killer H, Mugford M, Thalanany M, Tiruvoipati R, Truesdale A, Wilson A. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure. BMC Health Serv Res. 2006 Dec 23;6:163. doi: 10.1186/1472-6963-6-163. PMID: 17187683; PMCID: PMC1766357.

Stub D, Bernard S, Pellegrino V, Smith K, Walker T, Sheldrake J, Hockings L, Shaw J, Duffy SJ, Burrell A, Cameron P, Smit de V, Kaye DM. Refractory cardiac arrest treated with mechanical CPR, hypothermia, ECMO and early reperfusion (the CHEER trial). Resuscitation. 2015 Jan;86:88-94. doi: 10.1016/j.resuscitation.2014.09.010. Epub 2014 Oct 2. PMID: 25281189.

Belohlavek J, Smalcova J, Rob D, et al. Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2022;327(8):737–747. doi:10.1001/jama.2022.1025

Martje M. Suverein, M.D., Thijs S.R. Delnoij, M.D., et al. Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest. The INCEPTION trial. N Engl J Med 2023; 388:299-309. DOI: 10.1056/NEJMoa2204511

The Alfred ECPR Role Cards

The Bottom Line ECMO Reviews