EDECMO 30 – Post-Arrest ECMO Critical Care Management with Deirdre Murphy | EDECMO Podcast

The podcast explores critical care management of post-ECPR patients, focusing on the initial 24 hours after they return from the cath lab. Deirdre Murphy from The Alfred Hospital in Australia, a returning guest, shares her expertise on monitoring techniques, including the importance of right arm arterial lines and N-tidal CO2 for assessing native circulation. The discussion covers optimizing ECMO flow, balancing cannula size limitations with the need for adequate perfusion and addressing potential limb ischemia with distal perfusion cannulas. Murphy also addresses vasopressor and volume management, highlighting the need to tailor approaches based on individual patient responses, whether vasodilation or vasoconstriction. Ventilation strategies, hemoglobin targets, anticoagulation levels, and the importance of treating the patient holistically are also discussed.

Outlines

Part 1: Introduction, Monitoring Basics

Part 2: ECMO Flow, Perfusion, Optimization

Part 3: Volume, Ventilation, Clinical Management

Part 4: Holistic Care, Resources

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EDECMO 30 – Post-Arrest ECMO Critical Care Management with Deirdre Murphy

EDECMO Podcast

Part 1: Introduction, Monitoring Basics

Introduction to Post-Pump Critical Care with Deirdre Murphy

Essential Monitoring Techniques for Post-ECPR Patients: Arterial Lines and End-Tidal CO2

CVP Utility, Central Access Safety, and Site Selection in ECMO Patients

Part 2: ECMO Flow, Perfusion, Optimization

Optimizing ECMO Flow: Cannula Size, Distal Perfusion, and Limb Perfusion

Maintaining Native Perfusion, Monitoring Flow Adequacy, and Temperature Control

Vasopressor Titration: Addressing Vasodilation and Afterload Reduction in ECMO Patients

Part 3: Volume, Ventilation, Clinical Management

Volume Status Management: Addressing Venous Cannula Chattering and Fluid Administration

Ventilation Strategies: CO2 Targets, Sweep Gas Adjustment, and FiO2 Reduction

Native Lung Ventilation, Hemoglobin Targets, and Anticoagulation Considerations

Part 4: Holistic Care, Resources

Holistic Patient Care, Resource Recommendations, and Podcast Appreciation

EDECMO 30 – Post-Arrest ECMO Critical Care Management with Deirdre Murphy

EDECMO Podcast

Part 1: Introduction, Monitoring Basics

00:00Introduction to Post-Pump Critical Care with Deirdre Murphy

Introduction to Post-Pump Critical Care with Deirdre Murphy

01:09Essential Monitoring Techniques for Post-ECPR Patients: Arterial Lines and End-Tidal CO2

Essential Monitoring Techniques for Post-ECPR Patients: Arterial Lines and End-Tidal CO2

03:43CVP Utility, Central Access Safety, and Site Selection in ECMO Patients

CVP Utility, Central Access Safety, and Site Selection in ECMO Patients

Part 2: ECMO Flow, Perfusion, Optimization

05:31Optimizing ECMO Flow: Cannula Size, Distal Perfusion, and Limb Perfusion

Optimizing ECMO Flow: Cannula Size, Distal Perfusion, and Limb Perfusion

07:34Maintaining Native Perfusion, Monitoring Flow Adequacy, and Temperature Control

Maintaining Native Perfusion, Monitoring Flow Adequacy, and Temperature Control

09:46Vasopressor Titration: Addressing Vasodilation and Afterload Reduction in ECMO Patients

Vasopressor Titration: Addressing Vasodilation and Afterload Reduction in ECMO Patients

Part 3: Volume, Ventilation, Clinical Management

12:44Volume Status Management: Addressing Venous Cannula Chattering and Fluid Administration

Volume Status Management: Addressing Venous Cannula Chattering and Fluid Administration

14:39Ventilation Strategies: CO2 Targets, Sweep Gas Adjustment, and FiO2 Reduction

Ventilation Strategies: CO2 Targets, Sweep Gas Adjustment, and FiO2 Reduction

16:42Native Lung Ventilation, Hemoglobin Targets, and Anticoagulation Considerations

Native Lung Ventilation, Hemoglobin Targets, and Anticoagulation Considerations

Part 4: Holistic Care, Resources

20:29Holistic Patient Care, Resource Recommendations, and Podcast Appreciation

Holistic Patient Care, Resource Recommendations, and Podcast Appreciation