Critical Matters ECMO for Respiratory Failure
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Mar 14, 2024 The podcast discusses the role of ECMO in acute respiratory failure, covering historical developments, patient selection, and outcomes. It explores optimizing patient care with correct tidal volume and early engagement with the ECMO team. The chapter also touches on anticoagulation, complications, proning ARDS patients on ECMO, and weaning off ECMO support. Lessons from Shackleton's expedition highlight the importance of embracing change for better patient outcomes.
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Early ECMO Identification Saves Lives
- ECMO can provide a survival benefit in severe respiratory failure if patients are identified early and ventilator-induced lung injury is minimized.
- Building relationships with ECMO centers for timely transfer or optimization is crucial to improve outcomes.
ECMO Evolution and Pandemic Impact
- ECMO technology improved and pandemic experiences like H1N1 spurred renewed adult ECMO use around 2009.
- The CESAR trial showed transferring patients to ECMO centers improved survival by 10-20%, boosting ECMO confidence.
EOLIA Trial Supports ECMO Benefit
- The EOLIA trial showed up to 15% survival benefit with ECMO in severe ARDS but stopped early for futility due to crossover.
- Most clinicians adopt EOLIA criteria for ECMO candidacy despite inconclusive statistical significance.