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.

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.

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.

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.

"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.

Considerable progress has been made in component technology, circuitry, and clinical practice related to extracorporeal membrane oxygenation (ECMO). These advances allow prolonged support with fewer complications when compared to the past eras. Long-term support cases were frequently reported with indications including respiratory failure, cardiac failure, bridge to transplantation, extracorporeal cardiopulmonary resuscitation (ECPR), and even ambulatory extracorporeal membrane oxygenation (ECMO) support. The common complications associated with ECMO, including thrombosis, hemorrhage, nosocomial infection, neurological injury, vessel injury, multiple organ failure and mechanical failure, and the disease process of patients remain limiting factors. In spite of the complications, ECMO remains the only possible option in treatments for patients requiring long-term respiratory or cardiopulmonary support. In this chapter, the recent advances in long-term ECMO support are reviewed. Clinical etiology of patients placed on long-term ECMO support, the various circuit configurations, clinical and technical issues, management aspects, and clinical outcomes are discussed.

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.

Lung transplantation has become an increasingly important modality for the treatment of severe lung disease. From its inception, the procedure has been refined so that it now represents the standard of care for end stage respiratory failure. The widespread adoption of this treatment option, however, has brought into sharp relief the current organ donor shortage. In tandem with the explosion in lung transplant procedures, a number of support modalities have seen an expanded role. Perhaps one of the most versatile tools in the armamentarium of the pulmonary transplant surgeon is extracorporeal membrane oxygenation (ECMO). This powerful tool is being increasingly implemented in all stages of lung transplantation,Äîfrom supporting the failing native organ as a bridging tool to transplantation, to stabilizing the patient intra-operatively during the transplant procedure, to rescuing the patient with severe primary graft dysfunction immediately post-transplant. A number of advanced techniques for the application of ECMO in order to optimize the pulmonary transplant procedure are gaining traction,Äîand with ECMO,Äôs expanded role in lung transplantation, so also has come a new set of technical and ethical challenges that must also be overcome.

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.