To provide Critical Care providers with a working knowledgebase in the management of patients
on Veno-venous or Veno-arterial ECMO. The conference will be targeted to providers with
beginning to intermediate-level experience in ECMO management.
This will be a two-day conference that combines didactic lectures in the morning with wet-labs
and simulations in the afternoon. Wet-labs will generally be associated with the lectures that
precede. The anticipated capacity for attendees is a maximum of 50 which allows for small groups
during wet-labs of 6-7 people.
There will be an accompanying manual that will be co-produced by Emory University faculty
and faculty from participating hospitals in the Middle East region. Lecture content and wet-labs
will correlate with the manual content.
Instructors for didactic and wet-lab sessions will likewise be a mix of Emory faculty and regional
faculty with expertise in ECMO. The day prior to the conference, the Emory faculty will provide
training on the conference material and equipment.
Review the process for circuit priming, including recognizing common adverse events which
could occur during this process.
Identify the steps and process for cannulation and acknowledging complications that can arise.
Recognize alarms related to air in the circuit and understand the steps for removal of air
entrapped in the circuit.
Discuss the common causes of pump failure and the actions to address continuation of support
including hand cranking and circuit exchange when necessary.
Review complex patient cases and appropriately identify treatment and management options.
Focus on common issues with ECMO support which could result in hypoxia and how to properly
address and resolve these issues.
Recognize changes in hemodynamics as they relate to ECMO support and appropriately utilize
support to maximize patient outcomes.
Identify appropriate timing for decannulation and the complications which may arise during this
phase of ECMO care.
What Will You Learn?
- Exams (Pre & post-test): 15-20 questions per exam
- Introduction history: Conference welcome and brief introduction to the history of ECMO.
- Indications and contraindications: Review of data on outcomes and how informs patient selection. Balancing need for ECMO versus institutional resources.
- VV-ECMO Physiology: Review of normal respiratory physiology and how to match oxygenation/ventilation requirements using the ECMO circuit.
- VA-ECMO Physiology: Review of cardiac function, cardiac loading, perfusion requirements, and hemodynamics and how to match requirements using the ECMO circuit. Review of ventricular venting.
- Cannulation and configuration: Review of the basic steps in cannulation and initiation of ECMO flows. Review the advantages and disadvantages of different cannulation strategies. Review distal perfusion strategies. Assess needs for alternate or additional cannula configuration. Discuss single-lumen catheters and indications. Echocardiographic and radiologic evaluation of cannula positions.
- ECMO Physics and technology: Membrane function, pump and fluid dynamics, flows and pressures. Pump types. Sensors and safety components.
- Patient management principles: Practical considerations for daily management including transport, cannula care, monitoring, nutrition, mobilization, and physical rehabilitation.
- Pharmacology and anticoagulation: Pharmacokinetic considerations, sedation, and strategies for anticoagulation.
- Complications and emergencies: Management of common complications such as bleeding or hypoxia. Planning for and managing catastrophic emergencies such as pump failure or air entrainment.
- Weaning and decannulation: Weaning strategies from VV or VA ECMO, including recruitment strategies and tracheostomy considerations. Also discussing stopping the circuit in the setting of withdrawal of support (end-of-life care).
Day 1 Enrollment00:00