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 optimize your use of the machine.  This talk is a must for everyone starting ECPR in their departments. Marc’s ECMO physiology website Harvi Marc’s ASAIO article on ECMO physiology – Dickstein ML. The Starling Relationship and Veno-Arterial ECMO: Ventricular Distension Explained. ASAIO J. 2018 Jul/Aug;64(4):497-501. doi: 10.1097/MAT.0000000000000660. PubMed PMID: 29076945. Zack’s recent Resus Editorial on Impella Shinar Z. Is the "Unprotected Heart" a clinical myth? Use of IABP, Impella, and ECMO in the acute cardiac patient. Resuscitation. 2019 May 21. pii: S0300-9572(19)30173-X. doi: 10.1016/j.resuscitation.2019.05.005. [Epub ahead of print] PubMed PMID: 31125528

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