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EDECMO 93: Do you Blend? with Trina Augustin

EDECMO

Release Date: 12/26/2024

96: ECPR in India and China with Pranay Oza and Simon Sin show art 96: ECPR in India and China with Pranay Oza and Simon Sin

EDECMO

Zack Shinar interviews Pranay Oza, an intensivist from Mumbai, and Simon Sin, an intensivist from Hong Kong, about the insights, necessities, and opportunities for ECPR in India and China.  

info_outline EDECMO 95: ECPR Organ Procurement with Stephen Wall show art EDECMO 95: ECPR Organ Procurement with Stephen Wall

EDECMO

info_outline 94: Blending Revisited with Aidan Burrell show art 94: Blending Revisited with Aidan Burrell

EDECMO

In our last episode, Trina Augustin discussed whether we should use a Blender in ECPR patients citing the Blender Trial. This month we got the first author of the Blender Trial, Aidan Burrell, to give us insight into the use of blenders for not only ECPR patients but VA for cardiogenic shock and VV patients. Jon Marinaro interviews Aidan for this wonderful addition to this complex decision.

info_outline EDECMO 93: Do you Blend? with Trina Augustin show art EDECMO 93: Do you Blend? with Trina Augustin

EDECMO

This seems like such a basic question and yet the answer is not an answer at all.  Rather it is an educated opinion.  Today we ask the question - Should we blend ECPR patients? Here's the basic problem.  We think hyperoxemia in critically ill patients is bad (Remember hyperoxemia is high oxygen in blood, hyperoxia is high oxygen in the tissue).  We think that hypoxemia in critically ill patients is bad.  So if a patient gets put on ECMO and we can make the oxygen level coming out of the machine whatever level we want, what level should we set it at? Well, today, Trina...

info_outline EDECMO 92 - Mark Dennis show art EDECMO 92 - Mark Dennis

EDECMO

EDECMO episode 92 features Dr. Mark Dennis, a cardiologist from Sydney, who has published extensively in the field of ECPR.  Zack and Mark talk about so many subjects including pre-hospital considerations, algorithmic management of post ECMO initiation cardiac arrest patients, ventilation management of ECPR patients and much more. Prof Dennis would like to thank all the ambulance paramedics, ED docs, intensive care specialists, surgeons, radiologists, nurses and cardiologists across Sydney. Without their support none of the work would be possible. Also very special thanks to Natalie Kruit...

info_outline EDECMO 91 - Shock, Shock, Go show art EDECMO 91 - Shock, Shock, Go

EDECMO

Should we keep cardiac arrest patients on the scene when we have the ability to put them on ECMO in the hospital?  That is the question we tackle this month on EDECMO.  Brian Grunau and the great crew from Prague published a study looking at the Hyperinvasive trial data.  They make some profound observations about the benefits of ECPR and some data supporting transporting patients early in functional ECPR systems. Saul Levine and Jonathan Goldstone from the SDRC join the podcast this month to give their insight into the formation of ECPR receiving centers as well as the paper.

info_outline 90: ECMO in Trauma with Dr. Powell & Dr. O'Connor show art 90: ECMO in Trauma with Dr. Powell & Dr. O'Connor

EDECMO

In this episode of the ED ECMO Podcast, hosts Zack Shinar and Jon Marinaro interview Dr. Powell & Dr. O'Connor from Baltimore Shock Trauma, exploring ECMO's critical role in trauma care and its impact on patient outcomes. They discuss patient selection criteria for ECMO, managing hemorrhage and anticoagulation considerations, choosing between veno-arterial and veno-venous ECMO, practical insights on vascular access, and strategies for team coordination during ECMO emergencies. This discussion is essential for trauma surgeons, emergency physicians, critical care teams, perfusionists, and...

info_outline 89: What a Medical Student Should Know: Part 1 show art 89: What a Medical Student Should Know: Part 1

EDECMO

With the growing prevalence of ECPR, it is now more important than ever for all individuals in the medical community to understand what ECMO is, not just those providers who are directly involved with its use. In this new podcast series, Zack Shinar and Jon Marinaro help Nathaniel Dennis-Benford, a first-year medical student, explore what a medical student should know about ECMO and ECPR. In this first episode of the series, we start from the basics: what is "cardiac arrest", how is it traditionally managed, and finally what even is ECMO? 

info_outline EDECMO 88: Billing with John Mehall show art EDECMO 88: Billing with John Mehall

EDECMO

This episode is a must for your ECMO program.  John Mehall from Innovative ECMO Concepts goes through the financial aspects of ECMO care.  He covers everything from hospital charges to physician reimbursement to areas where hospitals commonly fail.  We all know that you cannot have a successful ECMO program unless you have sufficient funding to keep it going.  This episode is critical to maintain the billing aspects of specifically US ECMO programs.  Jon Marinaro, Zack Shinar, and an entire audience of Reanimate 9 attendees join the episode to ask questions and give...

info_outline EDECMO 87: Pearls from Prague and an Update on San Diego's ECPR initiative with Saul Levine show art EDECMO 87: Pearls from Prague and an Update on San Diego's ECPR initiative with Saul Levine

EDECMO

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More Episodes

This seems like such a basic question and yet the answer is not an answer at all.  Rather it is an educated opinion.  Today we ask the question - Should we blend ECPR patients?

Here's the basic problem.  We think hyperoxemia in critically ill patients is bad (Remember hyperoxemia is high oxygen in blood, hyperoxia is high oxygen in the tissue).  We think that hypoxemia in critically ill patients is bad.  So if a patient gets put on ECMO and we can make the oxygen level coming out of the machine whatever level we want, what level should we set it at?

Well, today, Trina Augustin teaches how this seemingly simple problem is actually quite complex.  Trina is an ECMO superstar.  She practices at Mayo in Rochester as CV Intensivist with a background in CC/EM.  She teaches the most complex part of Reanimate - post pump critical care and yes she cannulates patients as well.  Listen to Zack and Trina banter over this complex topic specifically focusing on the release of the Blender Trial.

EMCRIT ECMO Podcast with Trina that is awesome! - CV-EMCrit - MCS Minute Series: Differential Gas Exchange on Peripheral Femoral VA ECMO with Trina

Bibliography:

Winiszewski H, Guinot PG, Schmidt M, Besch G, Piton G, Perrotti A, Lorusso R, Kimmoun A, Capellier G. Optimizing PO2 during peripheral veno-arterial ECMO: a narrative review. Crit Care. 2022 Jul 26;26(1):226. doi: 10.1186/s13054-022-04102-0. PMID: 35883117; PMCID: PMC9316319.

Bureau C, Schmidt M, Chommeloux J, Rivals I, Similowski T, Hékimian G, Luyt CE, Niérat MC, Dangers L, Dres M, Combes A, Morélot-Panzini C, Demoule A. Increasing Sweep Gas Flow Reduces Respiratory Drive and Dyspnea in Nonintubated Venoarterial Extracorporeal Membrane Oxygenation Patients: A Pilot Study. Anesthesiology. 2024 Jul 1;141(1):87-99. doi: 10.1097/ALN.0000000000004962. PMID: 38436930.

Burrell A, Ng S, Ottosen K, Bailey M, Buscher H, Fraser J, Udy A, Gattas D, Totaro R, Bellomo R, Forrest P, Martin E, Reid L, Ziegenfuss M, Eastwood G, Higgins A, Hodgson C, Litton E, Nair P, Orford N, Pellegrino V, Shekar K, Trapani T, Pilcher D. Blend to Limit OxygEN in ECMO: A RanDomised ControllEd Registry (BLENDER) Trial: Study Protocol and Statistical Analysis Plan. Crit Care Resusc. 2023 Aug 4;25(3):118-125. doi: 10.1016/j.ccrj.2023.06.001. Erratum in: Crit Care Resusc. 2024 Feb 01;26(1):60. doi: 10.1016/j.ccrj.2024.01.003. PMID: 37876374; PMCID: PMC10581278.