3. ecmo different modes and principles va vv #beach2019 (taccone)
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This workshop will outline the basic principles of extracorporeal life support made easy by key-experts in the field. During the course delegates will gain a good understanding of ECMO in the following areas: Theoretical concepts, basic physiology and pathophysiology, cardiac and respiratory support and monitoring, alarm settings and monitoring, role of cardiac ultrasound during ECMO, newest technologies, circuits and devices, practical hands-on sessions and simulations.
3. ecmo different modes and principles va vv #beach2019 (taccone)
- 1. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 BEACH 2019 FS Taccone ECMO Principles and Different Modes Fabio Silvio TACCONE, MD, PhD Dpt of Intensive Care Brussels, Belgium
- 2. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3
- 3. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 WHAT IS ECMO ? V-V ECMO V-A ECMO
- 4. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 Extra-corporeal life support (ECLS) Cardiac ECLS Respiratory ECLS
- 5. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 RESPIRATORY ECLS VV-ECMO functions as an artificial lung working in addition to the patient's own failing lungs To maintain gas exchanges To allow protective ventilation To allow lung rest To allow lung recovery To gain time for LTx
- 6. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 RESPIRATORY ECLS < CO SvO2 VO2
- 7. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 RESPIRATORY ECLS
- 8. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 RESPIRATORY ECLS
- 9. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 RESPIRATORY ECLS VCO2
- 10. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 RESPIRATORY ECLS
- 11. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS ECMO FLOW = CARDIAC OUTPUT VOLUME x PUMP (CANNULA) LIMB ISCHEMIA LUNG INJURY HARLEQUIN SYNDROME
- 12. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 The best perfusion flow Off-load the left ventricle Almost no pulmonary edema Very invasive (chest opening) Bleeding Infection Vascular injury (Aortic dissection) Significant risk of thrombosis CARDIAC ECLS VA-ECMO Central Cannulation
- 13. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS
- 14. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS
- 15. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS ECMO FLOW = CARDIAC OUTPUT VOLUME x PUMP (CANNULA) LIMB ISCHEMIA LUNG INJURY HARLEQUIN SYNDROME INCREASED AFTERLOAD
- 16. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS
- 17. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS
- 18. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 CARDIAC ECLS
- 19. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 ECLS
- 20. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 ECLS AND OTHER EXTRACORPOREAL THERAPIES RRT MV LIVER SUPPORT HEMOPERFUSION
- 21. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3 Extra-corporeal life support (ECLS) Cardiac ECLS Respiratory ECLS VA-ECMO V-PA ECMO ECPR VV-ECMO V-PA ECMO AV-ECCO2R VV-ECCO2R Veno-artero-venous ECLS HYBRIDCOMBINED
- 22. BEACH 2019 FS Taccone T1T2T3T4T5T6 T7T8 T9 T10 T11T12L1L2L3
Editor's Notes
- #7: HOW IT WORKS ?
- #8: 47% vs 63% (22/90 not ECMO mortality 18%!!!) no difference on good outcome
- #10: HOW IT WORKS ?
- #11: 47% vs 63% (22/90 not ECMO mortality 18%!!!) no difference on good outcome
- #12: CARDIAC INJURY = afterload < increase BP / aortic regurgitation
- #13: Central cannulation when oxygenation is not needed anymore two circuits with cannulation of heart chamber (usually apex but also atria) excellent means of unloading the heart and maintaining the blood flow via pulmonary vasculature
- #14: Without the oxygenator it would be considered as a temporary VAD Femoral requires often a reperfusion catheter to avoid limb ischemia But also axillary or carotid
- #15: Without the oxygenator it would be considered as a temporary VAD Femoral requires often a reperfusion catheter to avoid limb ischemia But also axillary or carotid
- #16: CARDIAC INJURY = afterload < increase BP / aortic regurgitation