Acute Respiratory Failure Managed via Inter-Facility Transport for Extracorporeal Life Support: A 3-Year Experience

A Case Series of Devastating Intracranial Hemorrhage During Venovenous Extracorporeal Membrane Oxygenation for COVID-19

“…The authors' ECMO team consists of a multidisciplinary group that has managed a robust VV ECMO lung rescue program including the ability to perform mobile ECMO. 6,7 A decision was made to continue using VV ECMO during the COVID-19 pandemic with rigorous, multidisciplinary patient selection. Due to limited access to ECMO circuits and concern about an overwhelming number of consults for ECMO, the authors restricted the authors' previously published criteria 8 to the following:…”

“…The authors’ ECMO team consists of a multidisciplinary group that has managed a robust VV ECMO lung rescue program including the ability to perform mobile ECMO. 6 , 7 A decision was made to continue using VV ECMO during the COVID-19 pandemic with rigorous, multidisciplinary patient selection. Due to limited access to ECMO circuits and concern about an overwhelming number of consults for ECMO, the authors restricted the authors’ previously published criteria 8 to the following: Age <65 Absence of significant pre-existing comorbidities Mild or no limitations in physical activity prior to COVID-19 No or mild evidence of other end-organ damage from current disease Body mass index <45 (relative indication) Smoking history <30 packs/yr No cardiac arrest prior to cannulation Ventilator duration < or = 7 days …”

Looking Forward—Echocardiography in Venovenous Extracorporeal Membrane Oxygenation

“…The Penn Lung Rescue program, a mobile VV ECMO program based at Penn Presbyterain Medical Center in Philadelphia, uses a portable ultrasound machine with TEE capability for the majority of their ECMO cannulations, which usually occur at the ICU bedside. 6 Echocardiography is important not only during ECMO cannulation, but during all phases of care in this patient population. Indeed, the Extracorporeal Life Support Organization (ELSO) notes the importance of ultrasound, specifically echocardiography, in the pre-cannulation, cannulation, and post cannulation management of this patient population.…”

VV ECMO Cannulation: Should I Stay or Should I Go?

“…In this month's issue of the Journal of Cardiothoracic and Vascular Anesthesia, McDonald et al describe one of the largest adult mobile VV ECMO experiences in the United States. 2 The authors deserve recognition for their work as they have established a unique niche for US anesthesiologists. Clinical innovation is critical for anesthesiology's long-term success, and one area where US anesthesiologists can add value outside of the operating room may be ECMO.…”