PedsCrit
VA ECMO in Refractory Septic Shock, Part 2
Apr 7, 2025
Join Dr. Brian Bridges, Division Chief of Pediatric Critical Care Medicine, and Dr. Abhinav Totapally, pediatric intensivist, as they delve into the complexities of VA ECMO for refractory septic shock in children. They discuss the pros and cons of central versus peripheral cannulation, sharing personal experiences and insights on patient selection. The talk explores advancements in ECMO, emphasizing the impact of early intervention on outcomes, monitoring techniques, and the need for multidisciplinary care to tackle this critical condition effectively.
32:02
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Quick takeaways
- The podcast highlights the significant trade-offs between central and peripheral cannulation strategies for VA ECMO in pediatric septic shock management.
- Emphasizing realistic communication with families, the podcast discusses the unexpected complexities and expected outcomes of VA ECMO treatment in children.
Deep dives
Cannulation Strategies for VA ECMO
The podcast discusses the key considerations in choosing between central and peripheral cannulation strategies for VA ECMO in pediatric patients with septic shock. Central cannulation typically requires sternotomy and can offer higher blood flow and better drainage, which is crucial in such cases. However, it may involve more risks, including bleeding and infection, and requires availability of experienced cardiothoracic surgeons. Conversely, peripheral cannulation is more common and often quicker to perform, but it may result in lower blood flow due to size limitations of the vessels being accessed.
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