ICU Ed and Todd-Cast
New/Old: PRONECMO and EOLIA
Jan 2, 2024
Exploring the benefits of prone positioning during ECMO therapy for ARDS patients. Reflecting on the humility and challenges of critical care. Debating the use of medical terminology like 'Portuguese man award' and 'prone ECMO'. Delving into the efficacy of prone positioning and ECMO therapy for severe respiratory issues. Discussing the components and outcomes of the EOLIA study on ECMO therapy for ARDS. Analyzing the results of a clinical trial comparing ECMO to conventional treatment for severe ARDS.
55:10
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Quick takeaways
- Prone positioning during ECMO may not significantly impact outcomes, despite potential trends towards more ECMO weaning failures in the prone group.
- Specific ventilation strategies for ECMO patients, focusing on ultra-lung protective ventilation with low tidal volumes, raise questions about optimal management and highlight the need for further research in this area.
Deep dives
Prone Positioning and Its Impact on ECMO Weaning
The study delved into the application of prone positioning during ECMO treatment, aiming to accelerate ECMO weaning. Patients were prone for 16 hours each day for the first four days, showing a trend towards more ECMO weaning failures in the prone group (10.5% vs 3.6% in supine). However, overall mortality rates at 60 and 90 days were similar between the prone and supine groups, indicating no significant impact on outcomes.
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