This new edition presents an evidence-based review of extracorporeal membrane oxygenation (ECMO) for adults, with a particular focus on veno-venous (VV) ECMO. Due to the dramatic impact of COVID-19, the number of institutions offering ECMO, thus the number of clinicians performing ECMO (or referring their patients for ECMO), has exploded in a truly unprecedented way. While the pandemic may fade, programs built in response will survive by extending the application of ECMO to previously overlooked populations.

This fully updated second edition refines its focus to VV ECMO, which has seen the most dramatic increase and relevance. This allows expert authors to go further in depth regarding VV ECMO and provide readers with better guidance from the physiology of VV ECMO to weaning and decannulation. Several areas have been expanded, including anti-thrombotic approaches; how to set the mechanical ventilator and judge the complex interactions between patient, ventilator, and ECMO circuit; assessing the systemic circulation during VV ECMO (especially right ventricular function and intravascular volume); and recognizing membrane lung dysfunction. Finally, new chapters addressing how the VV-capable clinician should think about VA ECMO and how to incorporate ethical principles in patient selection and withdrawal of ECMO have been added.

This is an ideal guide for intensive care and respiratory medicine specialists, fellows training in critical care, ECMO specialist staff, perfusionists, nurses, and respiratory therapists.

Autorentext

Dr. Schmidt is Professor of Internal Medicine in the Division of Pulmonary Diseases, Critical Care, and Occupational Medicine at the University of Iowa. He also serves as Associate Chief Medical Officer for Critical Care at the University of Iowa Hospitals and Clinics and Chairs the Critical Care Subcommittee.

Dr. Schmidt's teaching and clinical investigation interests include critical care ultrasonography and echocardiography, ventilator waveform interpretation; extracorporeal life support; septic shock, ICU-acquired weakness; and ICU delirium. He has garnered teaching awards at both the University of Chicago and the University of Iowa. Dr. Schmidt has chaired many symposia on a broad range of critical care topics; authored numerous original articles, textbook chapters, and textbooks; conducts clinical research in the ICU; serves on several editorial boards; and teaches critical care to students, residents, and fellows. With Drs. Jesse Hall and John Kress, he co-edits Principles of Critical Care, published by McGraw-Hill, one of the premier textbooks in the field and now in its 4th edition.

Inhalt

Physiology of Extracorporeal Life Support (ECLS)

Circuits, Membranes, and Pumps

Modes of ECMO

Vascular Access

Hypoxemic Respiratory Failure: Evidence, Indications, Exclusions

Ventilator management during ECLS

Managing the Systemic Circulation: Volume Status and RV Function

Antithrombotic therapy for ECMO

Membrane Dysfunction

ECCO2R in Obstructive Diseases: Evidence, Indications, Exclusions

ECMO as a bridge to lung transplantation

Daily management of patients on VV ECMO

Crises During ECLS

Mobilization During ECLS ECMO Weaning and Decannulation

Veno-arterial ECMO in respiratory failure

Ethical Challenges in Extracorporeal Membrane Oxygenation