PODCAST · health
ED ECMO
by Zack Shinar, MD
EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.
Episodes
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75: Pulmonary Embolism and ECPR
In this short episode, Zack makes two points. One, it was tough to get to where we are with ECMO acceptance. Two, cardiac arrest patients in PEA should be considered for ECPR. Below is the full editorial Zack and Alice did recently in the Journal of Resuscitation on the topic. It was born out of…
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74: Do 70 year old’s deserve ECPR? A Deep Dive into the Economics of ECPR
Have you ever pondered whether all the work over ECPR was worth it? Even if you did save a few patients, does this really make sense from a societal standpoint? Am I giving up my life on a project where my efforts could be better elsewhere? Then this episode is for you (and me). This month I talk...
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73b: Conclusions for Hyperinvasive Trial with Jan Belohlavek
Here is the conclusion for the interview of Jan Belohlavek and his Hyperinvasive Trial
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73:The Hyperinvasive Trial with Jan Belohlavek
Wait...ECPR works? To the believers, this has been a foregone conclusion. To the rest of the world, the question of whether ECPR improves cardiac arrest survivorship has been in question. Jan Belohlavek and his Prague colleagues just presented their 8 year data showing better outcomes in cardiac...
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72: Should We All Switch To Bivalirudin?
Heparin has been the mainstay of anticoagulation for ECMO patients for years. In recent years, this has been challenged. Bivalirudin has b ecome a potential better anticoagulant. Troy Seelhammer in EDECMO episode 55 gave us some insight into this. This month Ryan Rivosecchi and his crew at UPitt...
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71: Should We Prioritize VV-ECMO over ECPR?
In this episode, we dive into the abyss of resource allocation. Much of the world is saying that the limited number of ECMO circuits should be used for COVID induced lung injury. This means that ECPR initiatives have been shut down or severely limited. Is this the right thing to do? What does the...
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70: REBOA REDUX – Management of Hemorrhagic Shock in Non-Trauma Patients – with Bellezzo & Zaf Qasim
In this episode Joe Bellezzo talks with Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) expert Zaf Qasim about NON-TRAUMA applications of aortic compression for control of non-compressible non-trauma torso hemorrhage.
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69: 2020 Synopsis
2020 was a crazy year. This month Zack goes through the biggest ECMO lessons learned in 2020. This is a short concise run through of ECPR, ECMO for COVID, Imaging, and Aortic Dissection. It's a reminder of how organization is so critical to the outcome of your ECMO program. He also reminds us how...
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68: ARREST – The First Randomized ECPR Trial Ever
The ARREST Trial is published! Demetris Yannopoulos, Jason Bartos and their army of rockstars have done it! This is the first randomized ECPR trial and it showed tremendous benefit of ECPR compared to traditional therapies. Zack explores this paper and their concurrent publication of process with...
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67: Da DO2: Fundamental ECMO Physiology with Sage Whitmore
Have you ever wondered about how initiating ECMO changes the cardiovascular physiology? Have you wondered what metrics you should be looking at when resuscitating a patient that has a beating heart and a ECMO flow? Dr. Sage Whitmore, an ED Intensivist from Nashville with ECMO training from...
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66: Crash VV ECMO
Have you ever wondered how you would crash someone onto VV ECMO? Have you ever wondered where is the best place to put the cannulas? Have stayed up late at night wondering which patients in your department could benefit from VV rather than VA ECMO? Then this is the episode for you!! After a few...
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65: ECPR Journal Club: Dual Sequential Defibrillation, CT after ECMO, and much, much more
This month we tackle a number of topics. Garrett Sterling is back again with Zack Shinar to talk about cutting edge resuscitation, ECMO, and the interplay between the two. Dual sequential defibrillation, CT after ECMO initiation, should you perform bystander CPR in the era of Covid, some US ECMO...
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64: Contraindicated??? – Long Live the Aortic Dissection with Garrett Sterling
In this episode, Zack Shinar introduces a new physician to the podcast - Garrett Sterling. Garrett and Zack discuss the sticky topic of ECMO for aortic dissection. This traverses everything from VA ECMO in ECPR to VVECMO for pulmonary edema. They go through the literature on the subject and make...
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63: Covid and ECMO – Who do we cannulate? with Jenelle Badulak
"Normal life is changing. It is now a covid 19 life" - Bin Cao I write this with some trepidation as well as pride in the role we get to play as we begin the surge of Covid 19 in the United States. Today we will address the use of ECMO in Covid with an expert in ECMO who is in the throws of the...
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62: Jason Bartos Take 2: The Future of ECPR Now
Last month you heard Jason talk about the ECPR program at the University of Minnesota. This month Zack and Jason talk about post initiation care and the crazy ECPR realities that Demetri, Jason and U of M have created. The sky is the limit for their team!
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61: Jason Bartos – ECPR Redefined
Jason Bartos and his crew at the University of Minnesota have revolutionized the concept of ECPR for out of hospital cardiac arrests. His crew are interventional cardiologists who take OHCA straight to the cardiac cath lab. They have initiate times of around 6-8 minutes and have neurologically...
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60: ECPR 2.0 with Scott Weingart
Today's episode focuses on the differences between ECMO physiology in the patient in cardiogenic shock versus the one in cardiac arrest.
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59: Partial REBOA and US PreHospital ECPR Revisited
This month we discuss two different topics we've recently had on the podcast. Albuquerque had started the first US prehospital ECPR program.... and now they have the first patient as well. Jon and Darren will share with us the exciting news. Second, we recently had Matt Martin on the podcast...
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58: First U.S. Pre-Hospital ECPR Program
The U.S. has seen pre-hospital programs spring up in Paris, UK, and Australia. It was thought that due to billing issues this could never happen in America....but it has. Jon Marinaro and Darren Braude have accomplished this against all odds. Zack interviews the two of them on how they were able…
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57: The New REBOA catheter – Perfecting the Partial Occlusion
Over the last two years, partial or intermittent REBOA has been thought to be a significant advantage over complete REBOA. How to do this and how to use our current imperfect catheters in this arena is still in question. Matthew Martin and his colleagues at Madigan Medical Center have published…
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56: Pressors, Fluid, or Flow – Optimizing ECMO Physiology
A post arrest patient just got initiated on ECMO. Do you give fluids, add pressors, or increase flow? Marc Dickstein, an anesthesiologist from Columbia University and an expert in the physiology of ECMO, talks with Zack about how to manage these patients, what diagnostics we need and how to...
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55 – Anticoagulation of the ECMO Patient with Troy Seelhammer
Do you give heparin to your ECMO patients? Well, let's rethink this. This episode is All Things Anticoagulation! Zack talks with Troy Seelhammer, an intensivist from Mayo Clinic Rochester. He manages ECMO patients in his daily practice there. He has become a master of the subject of...
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54: Confirmation of Wire Placement with Sacha Richardson
In this episode, Sacha Richardson talks with Zack about a problem common to all ECPR programs- how do we confirm the placement of the wires? During chest compressions and even in patients with a pulse, confirmation of which vessel you have cannulated can be difficult. Sacha shares some tricks and...
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53b: Resuscitationist Inserted Distal Perfusion Catheter with Chris Couch
In this episode, we again explore the world of the distal perfusion catheter. You heard from Joe Dubose the vascular surgeons point of view; now let's see how non-surgeon resuscitationists are dealing with this problem. You will hear from Chris Couch, a critical care trained emergency physician...
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53: Distal Perfusion Catheter with Joe Dubose
Episode 53 is all about the distal perfusion catheter12. We are inserting a 15-19 Fr catheter into the femoral artery. This limits the flow of blood to the affected extremity. Many institutions have gone to mandatory distal perfusion catheters. This episode is all about those catheters - when…
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52: Brain Freeze- Selective Retrograde Cerebral Perfusion for Intra-Arrest Neuroprotection
We've all heard of therapeutic hypothermia. Some of us have heard of deep hypothermia for traumatic arrest. But what about deep regional hypothermia of brain for cardiac arrest! Zack interviewed Rob Schultz, a CT surgeon resident from Calgary who is doing research on deep hypothermia of the brain...
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51 – Proximal Balloon Occlusion for Cardiac Arrest
You've heard of ECMO for cardiac arrest- utilizing a mechanical pump to aid in perfusion of the coronaries. What if you can't do ECMO? What if your resources are such that simply can't lug a 10 kilogram machine out into the field? Well, Jostein Brede may have something for you to consider. He and...
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50b Inter-Facility Transport of ECMO patients Part 2 of 2
This is part 2 of Transport of ECMO patients. Mikael Broman is one of the world's leaders on ECMO transport. He works at the Karolinska institute in Sweden and has and continues to publish in the arena of ECMO transport. As you will see, he offers a world of experience and certainly some critical...
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50a Inter-facility Transport of ECMO patients Part 1 of 2
This month we are looking at how to transport patients from one facility to another on ECMO. This is difficult task full of potential catastrophes. Zack interviews Leon Eydelman, an ER/Critical Care physician from Chicago, and Michael Broman out of Karolinska in Sweden. Leon will be bringing us…
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49 – You Can’t Spell REBOA without the ER – Endovascular Resuscitation of the Trauma Patient – Zaf Qasim
n this episode, Zack Shinar interviews Zaf Qasim about the recent controversies with ACEP and ACS about who can do REBOA. Zaf is one of the world's experts on REBOA and he's an ER doc! Zaf works at the University of Pennsylvania, trained in London as well as Shock Trauma in Baltimore and teaches…
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EDECMO 48: When Should I Transport a Cardiac Arrest?
This part two of August 2018. We are now tackling the difficult question of when to transport cardiac arrests if I have ECMO available? Brian Grunau is an expert in this question. Brian has become a giant in the world of ECMO. His research, leadership and experience have pushed the Canadian ECPR...
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EDECMO 47: ECMO Donazione: Organ Transplantation with Velia Antonini
Over this last year we have had episodes on organ donation and decision to transport. This month we are revisiting two topics with two amazing people in two separate episodes. Here, I interviewed Velia Marta Antonini. Velia works in Italy where several of the great ECMO donation papers have...
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EDECMO 46: Wire Assistant
Well, it only took us seven years to figure this one out. The wire assistant has been the key advancement of 2018 for placement of ECMO cannulas. In this episode, Zack and Joe talk through this process after an interview with Alyssa Baldini. Alyssa was one of our first true wire assistants and…
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EDECMO 45: ECMO in Sepsis
In this episode, Zack talks with Heidi Dalton about ECMO use in Sepsis. This is another controversial area with pediatric literature showing strong results while the adult results have been less impressive. Heidi has been a key figure in both adult and pediatric ECMO. She is the former chair of…
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EDECMO 44: Bob Bartlett: Peristaltic Pumps, Hollow Fibers, and the History of ECMO
In this episode, Zack interviews Bob Bartlett from the University of Michigan. He is truly the godfather of ECMO and has revolutionized the world with his leadership and innovation. They discuss the history of ECMO and roller pumps and bubble oxygenators were clearly inferior to their current...
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EDECMO 43: The Cutdown
In this episode, Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion. She is an emergency physician who is one of four physicians who take call on the pre-hospital ECMO ambulance. She describes the process of their modified cutdown. First, incision through...
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EDECMO 42: Organ Transplantation On ECMO
In this episode, we tackle the subject of organ transplantation on ECMO. 2017 featured several articles showing the efficacy of ECMO for organ transplantation. In Italy, 56% of total potential patients were successfully transplanted. The success of these transplants have been comparable to…
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EDECMO 41 – The 3 Stages of ECPR – Diane’s Story
In this episode Zack and Joe discuss the 3-stages of Extracorporeal Membrane Oxygenation (ECMO) - or put another way, this is how to start Extracorporeal Cardiopulmonary Resuscitation (ECPR) in the Emergency Department (ED). It's been 4 years since we talked about these basic premises of ECPR.…
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EDECMO 40: EROCA – The trial that asks “Should ER Docs Initiate ECPR?”
EROCA - University of Michigan - Gunnerson/Shinar Should Emergency Physicians initiate ECMO on arresting patients? That is the question that Kyle Gunnerson from the University of Michigan (UMich) is asking with their new trial - EROCA. UMich has had a robust ECMO program for over 30 years and...
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EDECMO 39: Who Do We Put On ECMO? – New Data on Prognostics
In this episode Zack interviews the first authors of the three biggest papers this year dealing with the question of “Who should I put on ECMO?” Guillaume Debaty of Grenoble, France published a paper outlining what prognostic factors are important. Guillaume's data shows importance of short low...
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Crash Episode: Iowa OHCA ECMO Save – with Andrew Karl Terry
Mini episode - This is a great example of where a little persistence with your colleagues can help save someone's life. Dr. Andrew Karl Terry, having had only limited exposure to ECMO, was able to encourage his Cardiologists to put a witnessed VF patient on ECMO. The rest is history!
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EDECMO 38 – ECMO and Trauma – with Pal Ager-Wick and Magnus Larsson
This episode is all about ECMO in trauma - not the usual ARDS, TRALI VV-ECMO - we’re talking about VA ECMO for the acutely dying trauma patient. Zack interviews Pål Ager-Wick from Tromso Norway, and Magnus Larsson from the Karolinska Institute in Stockholm. We talk about everything from how ECMO...
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EDECMO 37 – Nate’s Story
Jake is an Emergency Physician from Santa Cruz California whose interest in resuscitation was put to the fullest test when his own son had a cardiac arrest. This is the amazing retelling of that day in November when what Jake learned in an EDECMO workshop was utilized in a dramatic fashion. This…
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Crash Episode – MicroDissection of Yannopoulos’ ECMO Method
The University of Minnesota Cath Lab Cannulation Method
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EDECMO 36 – Crushing the Nihilism of Cardiac Arrest – with Demetris Yannopoulos
In this podcast episode, Zack interviews Demetri Yannopoulos from the University of Minnesota. Demetri has organized Minneapolis into arguably the most impressive ECPR city in the world. He has changed the mindset of out of hospital refractory ventricular fibrillation care from “stay and play”…
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EDECMO 35 – REBOA REVISITED!
REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) is used to gain proximal control over non-compressible hemorrhage below the diaphragm. In this episode, Zack takes a deep dive into REBOA implementation, physiology, and complications with four of the biggest movers in the world of...
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EDECMO 34 – The Day After REANIMATE – with Dr. Sean Deitch
In this episode, Joe talks with Dr. Sean Deitch, a non-academic Emergency Physician practicing in San Diego, California. Dr. Deitch attended REANIMATE 3 - which just finished 2 weeks ago...and has an amazing story to tell. You'll have to listen to the episode... REANIMATE 4 is September 21-22…
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EDECMO 33a – “Bringing Down the House” by Zack Shinar (from RESUSfest 2016)
In this episode of the EDECMO podcast, Zack describes how to use the concept of 'TEAM PLAY", much like the gang from the classic novel "Bringing Down the House" by Ben Mezrich, to optimize outcomes after cardiac arrest....with, or without, ECPR.
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EDECMO 32 – Archimedes Screw: Is Impella the Future of Mechanical Circulatory Support?
In this episode we explore two very different applications of the Impella® device - a percutaneously-placed temporary ventricular assist device (VAD) sold by Abiomed (no financial disclosures). These VADs work by the use of a micro-axillary pump which is typically placed by interventional...
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ABOUT THIS SHOW
EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.
HOSTED BY
Zack Shinar, MD
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Frequently Asked Questions
How many episodes does ED ECMO have?
ED ECMO currently has 92 episodes available on PodParley. New episodes are automatically indexed when they're published to the podcast feed.
What is ED ECMO about?
EDECMO.org is a non-commercial source to discover the life-saving potential of resuscitative extra-corporeal membrane oxygenation (ecmo) and extra-corporeal life support (ecls). We will teach you the skills and break down the logistics to allow resuscitationists to initiate ECMO in the ED or ICU.
How often does ED ECMO release new episodes?
ED ECMO has 92 episodes. Check the episode list to see recent publication dates and frequency.
Where can I listen to ED ECMO?
You can listen to ED ECMO on PodParley by clicking any episode. We provide an embedded audio player for direct listening, and you can also subscribe via your preferred podcast app using the RSS feed.
Who hosts ED ECMO?
ED ECMO is created and hosted by Zack Shinar, MD.
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