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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 (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.
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 : An Interdisciplinary Problem-Based Learning Approach" provides an overview of the latest techniques, management strategies and technology surrounding the clinical use of ECMO. This interdisciplinary book reviews the most common scenarios of ECMO in 62 chapters exploring the conditions and problems arising in ECMO practice. Each chapter begins with a stem case, followed by open questions to encourage critical thinking and enable the reader to follow the management strategies of the authors, who are world leaders in the field. Followed by an evidence-based discussion, each chapter concludes with multiple-choice questions for self-assessment. This book is current in its knowledge of organ systems and management and keeps pace with new ECMO technology and surgical techniques coupled with current guidelines for management. Starting with the history of ECMO to technical aspects, circuit biocompatibility and interaction with blood, drugs and flow physics, the volume continues into pediatric and adult sections, focussing on both respiratory and cardiovascular support, followed by a section on trauma. The volume then concludes with a section on neurologic complications and ethics, as well as rehabilitation and ambulation of ECMO patients. In addition, to reflect the current global health situation, this book also includes a chapter on ECMO management in patients suffering with COVID-19, to cover the most urgent and pressing questions around ECMO during the ongoing pandemic. This is the first ECMO book on the market to utilise a problem-based learning approach and as such is an important unprecedented project on ECMO education.
This book provides a comprehensive overview of mechanical circulatory support of the failing heart in adults and children. The book uniquely combines engineering knowledge and the clinician’s perspective into a single resource, while also providing insights into current and future development of mechanical circulatory support technology, such as ventricular assist devices, the total artificial heart and catheter-based technologies for heart failure. Topics featured in this book include: The history of mechanical circulatory device development. Fundamentals of hemodynamics support. Clinical management of mechanical circulatory devices. Surgical implantation techniques. Current limitations of device therapies in advanced heart failure. Advanced and novel devices in the development pipeline. Opportunities for advancement in the field. Mechanical Support for Heart Failure: Current Solutions and New Technologies is a must-have resource for not only physicians, residents, fellows, and medical students in cardiology and cardiac surgery, but also clinical and basic researchers in biomedical engineering with an interest in mechanical circulatory support, heart failure, and new technological applications in medicine.
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.
"As demonstrated in the first book, the management of patients with profound respiratory failure or cardiogenic shock has evolved significantly over the years with advances in diagnostic and therapeutic options. While the mortality for these often-overlapping problems remains high, progress in the multi-disciplinary approach to these complex clinical problems has improved survival substantially. The focus of this second book is to explore some of the advanced topics and current literature regarding the management of patients requiring extra-corporeal membrane oxygenation (ECMO). As illustrated in the spectrum of topics discussed, ECMO is not only a complex therapy in itself, but the challenges, problems, and complications that arise in this unique area of medicine require engagement by many diverse disciplines. While there are many physiological issues such as organ protection, management of circuit complications, and optimal lung and cardiac protection for recovery, the use of ECMO also introduces a variety of legal and ethical challenges, particularly end-of-life issues (including brain death) in patients for whom recovery, despite extra-corporeal support, is most likely futile. Each of the chapters, written by world-renowned experts in the field, highlights a different important aspect in understanding the complex dynamics of extra-corporeal support and its impact on human pathophysiology. While many of the topics discussed involve sophisticated concepts, each chapter was written with the goal of providing a comprehensive review suitable for any level of training and experience. Many of the topic discussed highlight the state-of-the-art literature along with expert experiences and perspectives as we try to learn more about the overlapping art and science of a field of medicine that has only recently been accepted as a mainstream treatment option. Students of ECMO, ranging from early stage healthcare providers to master physicians, will benefit from the insights presented"--