This month Zack gives some pearls from his travels to Prague for Jan Behlolavek’s ECPR school, Poland to meet with Marek Dabrowski, and ELSO with the entire crew.  Zack also interviews Saul Levine for the first of what may be a recurring conversation about the San Diego Resuscitation Consortium.  His efforts along with Kristi Koenig, Shawn Evans, Todd Baumbacher, and many others have paved the way for an OHCA ECPR protocol that may change more than just San Diego cardiac care.  Listen to Saul explain how the first 3 months of this process has expanded the minds of what cardi...

 

This episode is a follow up to last month’s episode with Nichole Bosson.  Zack interviews Vadim Gudzenko about the in-patient aspects and critical care doctor perspective on the Los Angeles OHCA ECPR program.  A few take homes are that EMS is critical to any OHCA ECPR program.  Nurses need support for these intense patients with high mortality.  And emergency physicians need to buy in to the idea of ECMO for cardiac arrest to make a successful program.

 

Upcoming Events

Sept – ELSO – Summary – 34th Annual ELSO Conference (cvent.com)

Oct – Pr...

One of the biggest questions in ECPR right now is how do we organize our system to provide ECPR in an effective and streamlined approach?  Nichole Bosson, Dave Shavelle and the army of L.A. ECPR enthusiasts have successfully implemented a multi-hospital ECPR receiving center program in Los Angeles.  In this episode, Zack talks with Dr. Bosson about how they started, what they learned, and where they are going.

 

A little about Dr. Bosson

She is the Assistant Medical Director at the Los Angeles County EMS Agency. She is an Associate Clinical Pro...

Jon Marinaro takes EDECMO through another great podcast.  This time he interviews Christine Stead, the CEO of ELSO.  She talks about how ELSO is setting up standards for ECMO programs to try to make ECMO care at all hospitals safer.  She talks about how she works also with the device industry.  This involves working with the FDA for future innovations and CMS for reimbursement issues.  She talks about the website and how to get your program certified.  Christine as a person is amazing.  She and her 5 person team runs an organization that has its hands in so many di...

In this episode Jon Marinaro joins the ED ECMO team and interviews his colleague Sundeep Guliani, MD about the use of an ECMO first strategy for Massive Pulmonary Embolism. Jon and Sundeep review the data and processes from their institution and from other institutions in the United States.  Could it be that ECLS could move the survival needle on this high mortality disease? Listen and find out!

Hobohm L, Sagoschen I, Habertheuer A, Barco S, Valerio L, Wild J, Schmidt FP,
Gori T, Münzel T, Konstantinides S, Keller K. Clinical use and outcome of...

In this episode, Jon Marinaro and Zack Shinar go through the hot off the press Inception trial.  The trial was touted as a negative ECPR study though many reasons make this trial different then the ARREST trial.  They go through several important take home points for practitioners starting or running an ECPR/ECMO program.

 

Inception Trial

https://www.nejm.org/doi/full/10.1056/NEJMoa2204511

In this podcast, Joe Tonna tells us how to approach hypothermia with ECPR patients.  He also goes through his paper RESCUE-IHCA giving us an immediate way to prognosticate in patients to use of ECMO or not.

Hypothermia – Resuscitation

Nakashima T, Ogata S, Noguchi T, Nishimura K, Hsu CH, Sefa N, Haas NL, Bĕlohlávek J, Pellegrino V, Tonna JE, Haft J, Neumar RW. Association of intentional cooling, achieved temperature and hypothermia duration with in-hospital mortality in patients treated with extracorporeal cardiopulmonary resuscitation: An analysis of the ELSO registry. Resuscitation. 2022 Aug;177:43-51. doi: 10.1016/j.resus...

In this episode,  Zack interviews Florian Schmitzberger who just published a fantastic study that incorporates fourteen leaders within the ECPR community to hash out the specific procedural steps associated with ECPR.

 

INCLUSION
• Age

This month Zack gives a few pearls from the recent Reanimate courses and annual ELSO meeting in Boston before he interviews Gowry Mork from Aarhus University about her fantastic recent paper.

Pearl #1 is about hand placement in cannulation.  Hold the ultrasound in your left an
d needle in right.  Once in the vessel, drop the US probe and take your left hand and gently hold the needle. With your right hand grab the wire far enough up to be to insert into the vessel in one push. Gowry’s paper has many interesting poin...

This month we are honored to have Neville Vlok on the show.  Neville has been one of the key physicians pushing for ECPR in South Africa.  In this episode, we explore what medicine and resuscitation looks like in South Africa, how ECMO has been utilized, and whether ECMO even makes sense in developing countries.

 

Vlok N, Hedding KA, Van Dyk MA. Saved by the pump: Two successful resuscitations utilising emergency department-initiated extracorporeal cardiopulmonary resuscitation in South Africa. S Afr Med J. 2021 Mar 2;111(3):208-210. doi: 10.7196/SAMJ.2021.v111i3.15366. PMID: 33944740.