by Steve Morgan & Sophie Connolly
Welcome to the learnECMO podcast series on ICN. In this podcast we are going to cover the essentials of ECMO haemodynamics.
There’s just a quick promotional preface to the physiology spiel. We have opened registration for SMACCannulate via the SMACC website or learnECMO.com. It’s a pop-up ECMO cannulation station, sponsored by Maquet, where random teams of 2 delegates get the chance to set an ECMO cannulation world record. Appropriate accolades and dividends will be provided for the victors.
There are also a few remaining places for the second ECMOresuscitate Sydney course of the year at St. Vincent’s. We are also finalising the details for learnECMO London on 1st July, which will be a cannulation masterclass. Keep an eye out for the learnECMO journal club posts, and if you want to contribute a review of an ECMO related publication get in touch via the website.
Back to the physiology. Haemodynamics literally means blood movement and thus is the physical study of flowing blood and the structures through which it flows. In bedside vernacular we tend to use haemodynamics to refer to accessible surrogate measurements of cardiovascular performance, such as vascular and chamber pressures or quantifications of macrocirculatory blood flow.
To understand the haemodynamic effects of ECMO we will consider the effects of the in-parallel VA circuit and the in-series VV circuit separately. The effect on cardiac performance can be best approached and compartmentalised by examining the impact of ECMO on each of the determinants of stroke volume: preload, afterload and contractility.
This podcast covers:
How can we best describe ventricular function and the effect of ECMO?
What factors influence the net effect of VA ECMO on patient haemodynamics?
What are the primary haemodynamic effects of VA ECMO?
How does cannulation site influence the haemodynamics of VA ECMO?
What do you do about a non-ejecting heart on VA ECMO?
What about the RV? How does the unique functional anatomy and physiology contribute to RV failure?
What are the haemodynamic effects of VA ECMO on the RV?
What are the haemodynamic effects of VV ECMO?
If you’re an ECMO enthusiast/expert and have an educational contribution that needs a platform, get in touch, we would love to hear from you.
Find us on twitter @learnECMO and check out learnECMO.com to register for courses and keep up to date with new FOAMed content.