BookGregory A Schmidt, editor.
Summary: This new edition presents an evidence-based review of extracorporeal membrane oxygenation (ECMO) for adults, with a particular focus on veno-venous (VV) ECMO. Due to the dramatic impact of COVID-19, the number of institutions offering ECMO, thus the number of clinicians performing ECMO (or referring their patients for ECMO), has exploded in a truly unprecedented way. While the pandemic may fade, programs built in response will survive by extending the application of ECMO to previously overlooked populations. This fully updated second edition refines its focus to VV ECMO, which has seen the most dramatic increase and relevance. This allows expert authors to go further in depth regarding VV ECMO and provide readers with better guidance from the physiology of VV ECMO to weaning and decannulation. Several areas have been expanded, including anti-thrombotic approaches; how to set the mechanical ventilator and judge the complex interactions between patient, ventilator, and ECMO circuit; assessing the systemic circulation during VV ECMO (especially right ventricular function and intravascular volume); and recognizing membrane lung dysfunction. Finally, new chapters addressing how the VV-capable clinician should think about VA ECMO and how to incorporate ethical principles in patient selection and withdrawal of ECMO have been added. This is an ideal guide for intensive care and respiratory medicine specialists, fellows training in critical care, ECMO specialist staff, perfusionists, nurses, and respiratory therapists.
Contents:
Physiology of Extracorporeal Life Support (ECLS)
Circuits, Membranes, and Pumps
Modes of ECMO
Vascular Access
Hypoxemic Respiratory Failure: Evidence, Indications, Exclusions
Ventilator management during ECLS
Managing the Systemic Circulation: Volume Status and RV Function
Antithrombotic therapy for ECMO
Membrane Dysfunction
ECCO2R in Obstructive Diseases: Evidence, Indications, Exclusions
ECMO as a bridge to lung transplantation
Daily management of patients on VV ECMO
Crises During ECLS
Mobilization During ECLS
ECMO Weaning and Decannulation
Veno-arterial ECMO in respiratory failure
Ethical Challenges in Extracorporeal Membrane Oxygenation.