Conrad SA, Broman LM, Taccone FS, Lorusso R, Malfertheiner MV, Pappalardo F, Nardo MD, Belliato M, Grazioli L, Barbaro RP, McMullan DM, Pellegrino V, Brodie D, Bembea MM, Fan E, Mendonca M, Diaz R, Bartlett RH. The Extracorporeal Life Support Organization Maastricht Treaty for Nomenclature in Extracorporeal Life Support. A Position Paper of the Extracorporeal Life Support Organization. Am J Respir Crit Care Med. 2018 Apr 3.

A month of ECMO/ECLS (research): an (incomplete) selection of noteworthy articles published in the last month of February, just follow the links… about one half free open access!

LA decompression and/or LV unload on veno-arterial support:
Simultaneous Venoarterial Extracorporeal Membrane Oxygenation and Percutaneous Left Ventricular Decompression Therapy with Impella Is Associated with Improved Outcomes in Refractory Cardiogenic Shock.

A retrospective review of patients treated for refractory cardiogenic shock, comparing outcome between VA ECMO & VA-ECMO + Impella #ECPELLA cohort:
Patel SM, Lipinski J, Al-Kindi SG, Patel T, Saric P et al. ASAIO J. 2018 Feb 27.

Intra-aortic balloon pump protects against hydrostatic pulmonary oedema during peripheral venoarterial-extracorporeal membrane oxygenation.

Retrospective evaluation of Intra-Aortic Balloon Pump efficacy in preventing pulmonary edema in VA-ECMO-assisted patients:
Bréchot N, Demondion P, Santi F, Lebreton G, Pham T et al. Eur Heart J Acute Cardiovasc Care. 2018 Feb;7(1):62-69.

Percutaneous balloon atrial septostomy on top of venoarterial extracorporeal membrane oxygenation results in safe and effective left heart decompression. Eur Heart J Acute Cardiovasc Care.

Retrospective evaluation of safety and efficacy of balloon atrio-septostomy strategy for left atrial discharging in adults and children:
Baruteau A, Barnetche T, Morin L, Jalal Z, Boscamp N et al. 2018 Feb; 7(1):70-79.

Peripheral VA-ECMO with direct biventricular decompression for refractory cardiogenic shock.

…and a case rep of novel technique that combines peripheral VA-ECMO with direct ventricular decompression via a trans-apical left ventricular venting cannula and right ventricular decompression cannula: Rao P, Mosier J, Malo J, Dotson V, Mogan C et al. Perfusion. 2018 Feb 1.

Percutaneous Mechanical Circulation Support Combined with Extracorporeal Membrane Oxygenation (oxyRVAD) in Secondary Right Heart Failure.

Right heart failure??
Feasibility of long-term use of an ECMO-based percutaneous right ventricular assist system as bridge-to-recovery/to-transplant in the management of patients with severe right heart failure because of pulmonary hypertension, a case series:
Lepper PM, Hörsch SI, Seiler F, Kamp A, Becker SL et al. ASAIO J. 2018 Feb 6. open access

Utilization of Veno-Arterial Extracorporeal Membrane Oxygenation for Massive Pulmonary Embolism.

ECLS in pulmonary embolism and/or in pulmonary endarterectomy:
Retrospective revision of effectiveness/outcome of an aggressive, protocolized approach of VA-ECMO to triage, optimize, and treat patients with massive pulmonary embolism:
Pasrija C, Kronfli A, George P, Raithel M, Boulos F et al. Ann Thorac Surg. 2018 Feb;105(2):498-504. open access

Short-term venoarterial extracorporeal membrane oxygenation for massive endobronchial hemorrhage after pulmonary endarterectomy.

Intraoperative switch from cardiopulmonary bypass to venoarterial ECMO support with full-dose protamine administration in patients with massive endobronchial bleeding after Pulmonary EndArterectomy as potentially life-saving treatment concept:
Guth S, Wiedenroth CB, Wollenschläger M, Richter MJ, Ghofrani HA et al. J Thorac Cardiovasc Surg. 2018 Feb;155(2):643-649.

Extracorporeal membrane oxygenation in severe respiratory failure resulting from burns and smoke inhalation injury.
Extracorporeal support to provide advanced life support in adult trauma patients:

Retrospective analysis of veno-venous ECMO support as rescue intervention in small cohort of patients with flame type burns and smoke inhalation injury:
Szentgyorgyi L, Shepherd C1 Dunn KW, Fawcett P, Barker JM et al. Burns. 2018 Feb 27.

Past and present role of ECMO in combat casualty care: how far will we go?

Review describing the historic underpinnings of ECMO, recent experience during combat operations and assessment of current status of the UD Department of Defense ECMO program and the way forward to establish long-range lung rescue therapy as a routine capability for combat casualty:
Cannon JW, Mason PE, Batchinsky AI. J Trauma Acute Care Surg. 2018 Feb 13.

Predictors of hospital mortality in adult trauma patients receiving extracorporeal membrane oxygenation for advanced life support: a retrospective cohort study.

A retrospective study aimed at identifying the independent predictors of hospital mortality in adult trauma patients receiving ECMO for advanced cardiopulmonary dysfunctions.
Wu MY, Chou PL, Wu TI, Lin PJ. Scand J Trauma Resusc Emerg Med. 2018 Feb 8;26(1):14. open access

International ECMO Network (ECMONet) and The Extracorporeal Life Support Organization (ELSO). Position paper for the organization of ECMO programs for cardiac failure in adults.

Veno-arterial support in cardiogenic shock
Position paper highlighting key aspects of extracorporeal support delivery in cardiac failure, advocating for a multidisciplinary team of experts to guide ECMO support, rigorous patient selection, attention to complications and concentration of the most complex care at high-volume centers with advanced cardiac capabilities:
Abrams D, Garan AR, Abdelbary A, Bacchetta M, Bartlett RH, et al; Intensive Care Med. 2018 Feb 15.

Extracorporeal life support in cardiogenic shock: indications and management in current practice.

Review discussing indications, clinical management and complications of VA support in cardiogenic shock refractory to conventional treatment strategies:
Meuwese CL, Ramjankhan FZ, Braithwaite SA, de Jonge N, de Jong M, Buijsrogge MP2 et al. Neth Heart J. 2018 Feb;26(2):58-66. open access

Ex utero intrapartum treatment-to-extracorporeal membrane oxygenation followed by cardiac operation for truncus arteriosus communis.

Extracorporeal membrane oxygenation as an ex utero intrapartum treatment procedure for placental support in a fetus with truncus arteriosus communis and hydrops with ventricular failure due to severe truncal valve stenosis at 34 weeks of gestation, a case rep:
Asai H, Tachibana T, Shingu Y, Matsui Y. Interact Cardiovasc Thorac Surg. 2018 Feb 1;26(2):353-354. open access

Echocardiographic Guidance and Troubleshooting for Venovenous Extracorporeal Membrane Oxygenation Using the Dual-Lumen Bicaval Cannula
ECMO cannulae & cannulation procedure

Review (illustrated with many supplementary TTE, CXR, CT images) about the role of echocardiography to guide initial placement of the dual-lumen catheter and evaluate the cause of persistent hypoxemia during VV ECMO support:
Griffee MJ, Tonna JE, McKellar SH, Zimmerman JM. J Cardiothorac Vasc Anesth. 2018 Feb;32(1):370-378.

Reducing the Risk of Cardiac Perforation During Placement of Bicaval Veno-Venous Extracorporeal Membrane Oxygenation Cannulae.

Should additional steps be taken to reduce occurrence of cardiac perforation during dual lumen bicaval cannula placement? letter to the editor:
Charlesworth M, Ashworth AD. J Cardiothorac Vasc Anesth. 2018 Feb;32(1):e19-e20. open access

Novel Leg Cannula for Venous Decompression in Peripheral Extracorporeal Membrane Oxygenation.

Leg venous cannula to avoid distal leg congestion related to overperfusion in peripheral venoarterial ECMO with surgical cannulation of femoral artery, description of two pediatric cases:
Luo S, Foreman C, Sano M, Soto Agüero MJ, Guerguerian AM et al. Ann Thorac Surg. 2018 Feb;105(2):e95-e97. open access

Extracorporeal Membrane Oxygenation-Associated Infections: Carefully Consider Cannula Infections!

Finally, do not forget that cannulae are a potential source of infection on ECMO support: letter to the editor:
Messika J, Schmidt M, Aubry A, Combes A, Ricard JD. Crit Care Med. 2018 Feb;46(2):e171-e172.

Ventilation during extracorporeal support: Why and how.
Veno-venous support in respiratory failure

Evolving management of lung protection & ventilation during ECMO:
Pesenti A, Carlesso E, Langer T, Mauri T. Med Klin Intensivmed Notfmed. 2018 Feb;113(Suppl 1):26-30. open access

The Evolution of Extracorporeal Membrane Oxygenation for Adult Respiratory Failure.

Evolving use of extracorporeal membrane oxygenation to support patients with respiratory failure, growing evidence base for its use, unanswered questions & ongoing research: Brodie D. Ann Am Thorac Soc. 2018 Feb;15(Supplement_1):S57-S60. open access

The effect of multidisciplinary extracorporeal membrane oxygenation team on clinical outcomes in patients with severe acute respiratory failure.

Retrospective cohort study evaluating survival rate in patients treated with ECMO for severe acute respiratory failure after implementing a multidisciplinary ECMO team:
Na SJ, Chung CR, Choi HJ, Cho YH, Sung K et al. Ann Intensive Care. 2018 Feb 27;8(1):31. open access

Acceptance and transfer to a regional severe respiratory failure and veno-venous extracorporeal membrane oxygenation (ECMO) service: predictors and outcomes.

Referral of patient to an ECMO center and transport on extracorporeal support:
Evaluation of decision-making process leading to different outcomes in referrals to an ECMO center and identification of associated factors:
Gillon SA, Rowland K, Shankar-Hari M, Camporota L, Glover GW et al. Anaesthesia. 2018 Feb;73(2):177-186. open access

Management of Surge in Extracorporeal Membrane Oxygenation Transport.

Retrospective review of the outcome of patients transported while supported with ECMO:
Salna M, Chicotka S, Biscotti M III, Agerstrand C, Liou P et al. Ann Thorac Surg. 2018 Feb;105(2):528-534. open access

In Vitro Adsorption of Analgosedative Drugs in New Extracorporeal Membrane Oxygenation Circuits.

Medication administration on ECMO
In vitro experimental study evaluating paracetamol, morphine, midazolam, fentanyl, and sufentanil
disposition in extracorporeal membrane oxygenation circuits.
Raffaeli G, Allegaert K, Koch B, Cavallaro G, Mosca F et al. Pediatr Crit Care Med. 2018 Feb 6.

Bleeding and Thrombotic Complications in the Use of Extracorporeal Membrane Oxygenation.
Complications of extracorporeal support

A review about dealing with bleeding and thrombosis in patients on ECMO:
Thomas J, Kostousov V, Teruya J. Semin Thromb Hemost. 2018 Feb;44(1):20-29.