The Practice and Principles of Extra-Corporeal Membrane Oxygenation (ECMO)


Michael S. Firstenberg (Editor) – Chair, Cardiothoracic and Vascular Surgery, The Medical Center of Aurora, CO, USA

Series: Medical Procedures, Testing and Technology
BISAC: MED003040

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.



Table of Contents


Chapter 1. Extracorporeal Membrane Oxygenation in the Setting of Mechanical Complications of Myocardial Infarction
(Hellmuth R. Muller Moran and Michael H. Yamashita, Division of Cardiac Surgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada)

Chapter 2. Optimal Management of Respiratory Failure and Mechanical Ventilation during Extracorporeal Membrane Oxygenation
(Aniket S. Rali, MD, Christopher M. Howard, MD, J. Patrick Herlihy, MD, Alexis E. Shafii, MD, and Subhasis Chatterjee, MD, Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Baylor College Medicine, Houston, Texas, USA, and others)

Chapter 3. Extracorporeal Membrane Oxygenation and Acute Kidney Injury
(Bijin Thajudeen and Iyad Mansour, Department of Nephrology, Banner University of Arizona, Tucson, AZ, USA)

Chapter 4. Anticoagulation Pharmacotherapy in ECMO
(Craig J. Beavers and H. Andrew Wilsey, Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA, and others)

Chapter 5. Refractory Hypoxemia on Venovenous ECMO
(Omar Al-Qudsi, Ohio State University, Columbus, OH, USA)

Chapter 6. Left Ventricular Unloading in Peripheral Veno- Arterial Extracoporeal Membrane Oxygenation
(Mehul Desai, Erik Osborn, Jim Lantry, Alexander G. Truesdell, Chris King, Behnam Tehrani, Wayne Batchelor, Dan Tang and Ramesh Singh, INOVA Heart and Vascular Institute, Falls Church, Virginia, USA, and others)

Chapter 7. Total Percutaneous Approach in Peripheral VA-ECMO: How to Cannulate and Decannulate the Arterial ECMO Catheter and the Distal Perfusion Catheter
(S. Y. Au and G. W. Y. Ng, Department of Intensive Care, Queen Elizabeth Hospital, Hong Kong Special Administrative Region, China)

Chapter 8. ECMO Complications
(James Lantry III, Mehul Desai, Erik Osborn and Christopher King, NOVA Heart and Vascular Institute, Falls Church, Virginia, USA)

Chapter 9. Monitoring Brain Injuries in Extracorporeal Membrane Oxygenation
(Abdelaziz Farhat, Neel Shah, Poornima Pandiyan and Lakshmi Raman, Pediatric Critical Care, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA, and others)

Chapter 10. Multidisciplinary Team-Based Management of Cardiogenic Shock
(Alexander G. Truesdell, Mehul Desai, Aaron Bagnola, Erik Osborn, Carolyn Rosner, Ramesh Singh, Shashank Sinha, Daniel Tang, Behnam Tehrani, Timothy S. Welch, Charles Murphy and Wayne Batchelor, Virginia Heart, Falls Church, Virginia, USA, and others)

Chapter 11. Brain Death in Patients Supported by Extracorporeal Membrane Oxygenation
(Allison Ferreira, Department of Emergency Medicine, University of California – Los Angeles, Los Angeles, CA, USA)

Chapter 12. The Practice of Medicine and the Law
(James M. Arrowood, Attorney at Law, Arrowood Helbert PLLC, Scottsdale, Arizona)

Chapter 13. Biomaterials in Novel ECMO/ECLS Design: Oxygenator, Cannula, and Pump
(Serdar Gunaydin, Emre Kulahcioglu and Kevin McCusker, Department of Cardiovascular Surgery, City Hospital, University of Health Sciences, Ankara, Turkey, and others)

Chapter 14. Is There Any Role for Extra Corporeal Carbondioxide Removal?
(Harlinde Peperstraete, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium, and others)

Chapter 15. Advanced Cardiac Surgery without ECMO
(Fevzi Sarper Türker, Zeki Temiztürk, Davut Azboy and Mustafa Bilge Erdoğan, Cardiovascular Surgery Clinic, Education and Training Hospital, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey, and others)

Chapter 16. Mechanical Ventilation during Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) for Acute Respiratory Distress Syndrome (ARDS)
(Mathew Lacey, Tarek Elshazly, Olivia Giddings and Rana Hejal, Department of Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, USA)

Chapter 17. Left Ventricular Venting During Veno-Arterial ECMO
(David Drullinsky and Duc Thinh Pham, Division of Cardiac Surgery, Department of Surgery, Northwestern University, Chicago, IL, USA)

Chapter 18. Implications for Bedside Nurses Caring for the Critically Ill Patient Requiring ECMO
(Ryan Szilagyi and Alex Botsch, HCA Healthcare, Continental Division, Aurora, Colorado, USA)

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