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Extracorporeal membrane oxygenation (ECMO), despite a long and troubled history, is very rapidly evolving into a therapy that can be safely and effectively applied across the world in patients experiencing acute cardiac and/or pulmonary failure. As experiences grow, there is a better understanding of nuances of the importance of teamwork, therapy guidelines and protocols, patient selection, and understanding the functional aspects of pump-circuit technology as it interfaces with human biology. The challenges in managing these very sick and complex patients cannot be understated. The goal of this text is to provide a framework for the development and successful growth of a program. Authors from Centers of Excellence Worldwide have shared their experiences in the full spectrum in dealing with this evolving field.
Extracorporeal membrane oxygenation is an effective tool for managing patients with severe acute cardiogenic shock and/or respiratory failure. With emphasis on teamwork and adherence to guidelines, protocols, and objective tools to assist in patient selection, management, and weaning, outcomes have improved. Nevertheless, every aspect of supporting patients who require extracorporeal support remains a challenge - with many unanswered questions. The goal of this text, as a supplement to the previous editions on this rapidly evolving topic, is to provide the reader with a more in-depth review of some of the ongoing issues in this field. Topics ranging from administrative aspects to developing a program, nursing issues, ethical concerns, and a variety of clinical topics are discussed at length.
Most patients with critical cardiac or thoracic conditions will at some stage pass through the cardiothoracic critical care unit. Critical care presents more complex clinical data than any other area of medicine. The new edition of Core Topics in Cardiothoracic Critical Care focuses on the latest practise in the management of patients in cardiothoracic intensive care. The practice of cardiothoracic critical care medicine is constantly evolving, and this new edition reflects the modernized learning styles for trainees. Each chapter includes key learning points as well as sample multiple choice questions and answers to assist in exam preparation. This edition also features updated chapters on ECMO, perioperative management of patients undergoing emergency cardiothoracic surgery, and advanced modes of organ support for patients. This text provides key knowledge in a concise and accessible manner for trainees, clinicians and consultants from specialities and disciplines such as cardiology and anaesthesia, and nursing and physiotherapy.
This work provides a one-of- a-kind volume that includes all aspects of heart transplantation from its historic beginning to its current day standards which now make the procedure a long-term treatment option for heart failure patients. The subjects covered include technical aspects of the procurement and implant procedures, as well as the medical nuances of pre-operative preparation and post-transplant immunosuppression management; the current day multi-disciplinary make up of the transplant team along with information on the keys to building and running a successful transplant program; regulatory standards and listing policies and the impact of the growing mechanical circulatory support technologies on the transplant field; and emerging technologies and future possibilities. All chapters are written by experts in the field and include the most up-to-date peer reviewed studies and clinical guidelines. This book gives an ever-changing reference that will become the text of choice for those beginning or continuing their transplant careers.
Extracorporeal membrane oxygenation (ECMO) has evolved into an exciting and valuable tool to assist in the management of patients experiencing cardiogenic shock, severe acute respiratory failure, or often a combination of both. While outcomes remain less than ideal, they continue to improve with team experience, better patient selection, and a growing understanding of the nuances of managing patients who require mechanical circulatory support. Patients requiring ECMO are often extremely sick and have complex problems - initiating therapy before the development of end-organ damage is critical. Without doubt, teamwork, guidelines, and protocols are cornerstone concepts for clinical and program success - all topics that are emphasized in this text. The goals of this text are to further outline topics that help address some of the key challenges providers face when considering and applying extracorporeal support therapies to the evolving spectrum of acutely ill patients.
This volume provides a definitive look at heart, lung, and heart-lung transplantation. It includes historical background on these procedures, and discusses the immunological basis of transplantation, organ preservation, donor procurement, pre-transplant recipient management, operative techniques, post-operative care, pathology, special considerations (cystic fibrosis, etc.) lung transplantation (results and complications) and future prospects, including a chapter on xenotransplantation by Columbia's Keith Reemtsma.
Part of the Core Critical Care series, this book is an easy-to-read guide for the aspiring ECMO clinician. Doctors, nurses, physiotherapists, dieticians, pharmacists and all other key members of the team will learn the basics required to better understand the technology and care of the patient.
Cystic fibrosis, a genetic disorder in children and young adults, is a multisystemic disease that mainly affects the lungs. Advances and improvements in the diagnosis and management of this condition have led to increased overall and symptom-free survival in cystic fibrosis patients. This book examines recent advances in the field and presents an evidence-based approach to the management of cystic fibrosis.