🩸 Hemorrhagic risk in VA #ECMO is complex! RBC transfusion exposure is by far higher than in other critically ill populations. #ECPR & antiplatelets act as additional risk factors. Transfusion practice for variable, does not always follow international guidelines. #FOAMcc #FOAMecmo 🔓 rdcu.be/e70k0

📖 VA #ECMO: Chapter 16 is focused on pediatric & neonatal patients requiring circulatory support 🩺 indications 🩸 cannulation strategies 🩺 management 🫀 weaning off 🚧 complications & outcomes 📘 The Blue Book: latest edition of ELSO #ECMO Specialist Training Manual is available! 🛒 bit.ly/ELSObooks

📢 Join the ELSO Registry Development Committee Q&A ❓ session: come and ask questions about entering data to or about Data Definitions, or suggest future updates! 🖥️ virtual meeting (Zoom platform) 🔓 open, no registration required 📆 March 18 ⏰ PM US Eastern Time All are welcome! 🔗 bit.ly/ELSORegQA26

#ECMO without anticoagulation: are we there yet? 🩸 Novel coatings, strategies as NO in SGF, new anticoagulants hold promise of reduce risks. Awaiting further evidence, anticoagulation-free #ECLS should be an exception, maybe safe in some highly selected adults on VV with relatively high blood flows.

Antimicrobial stewardship in #ECMO? Challenging & evolving discipline, w limited data available! 🧫 PK alterations induced by circuits + prolonged ICU stays + high infection risk make optimal ABT therapy complex. Evidence for use of stewardship in #ICU remains applicable to #ECLS. 🔗 bit.ly/4cXVzlj

Understanding lung physiology through ventilator screen 🫁 airway pressure waveform: equation of motion, conductive P, stress index, DP 🌊 flow waveform during PCV 💨 expiratory flow/time constant 🛌 dynamic bedside maneuvers: AOP, recruitability & recruitment-to-inflation ratio #FOAMcc 🔓 rdcu.be/e6iG6

The evolution of deceased organ donation in the US 🇺🇸 📋 historical & legal framework 🔍 donor epidemiology ⚖️ policy modernization 🩸donor evolution in the era of perfusion & preservation: NRP, NMP, HOPE 🔮 implications and future directions @jama.com 🔗 bit.ly/3MLW1IV

Argatroban in #ECMO? First prospective randomized controlled pilot trial to compare argatroban vs UFH as first line maintenance anticoagulation 🩸no difference in incidence/time to event regarding bleeding events/thrombosis 🩸RBCs/PLTS transfusion requirement similar #FOAMcc #FOAMecmo 🔓 bit.ly/4szm05J

2026 @ahascience.bsky.social ACC guideline for evaluation/management of acute PE in adults 📋 definitions/classifications 🩺 evaluation/diagnosis 🩸 acute management 🖥️ monitoring/follow-up 🚧 complications/sequelae 🔍 evidence gaps/future directions With recommendations on #ECMO, see 🧵 🔓 bit.ly/4tNACzF

🫀🐖 The 2026 @ishlt.bsky.social consensus statement on clinical cardiac xeno #transplantation summarizing evidence-based + theoretically founded recommendations for selection/management of xenograft recipients, and informed guidance on design/oversight of near-term clinical work. 🖇️ bit.ly/4rzqqcG

Integrating #CRRT into ex-situ normothermic liver machine perfusion? To ⚖️ support solute clearance 💦 reduce edema maintaining stable dynamics + improving graft during extended NMP. Here, reproducible & safe method to connect CVVHDF into NMP + how to prime, monitor & manage. 🖇️ bit.ly/4roiMS2

Too much of a good thing? Hyperoxemia in acute brain injured pts 🧠 hypoxic-ischaemic encephalopathy 🧠 other acute brain injuries How to balance competing risks of hypo vs hyperoxemia? Hypoxemia to be vigilantly avoided but excessive O2 exposure may contribute to secondary BI #FOAMcc 🔓 rdcu.be/e4wuW

𝗥𝗲𝗺𝗶𝗻𝗱𝗲𝗿: Applications are open for the Transplant Science Summer School 2026 (11–13 June, Kraków). Early-career professionals in transplant science are encouraged to apply. 📅 Deadline: 15 March 2026 #ESOT_BasicScience #ESOTeducation

#ECMO center volume: any association with #ECLS related complications? Analysis of @theelso.bsky.social Registry. Higher volume may lead to ⬆️ experience translating to ⬆️ vigilance = early detection of ECMO complications, but also to initiation within larger, more complex population. 🖇️ bit.ly/3MP3mr1

📘 Blue Book: #ECMO Specialist Training Manual chapter 13, #ECLS circuit & component changes ⚙️ pt management ⚙️ change-out supplies/procedure ⚙️ circuit & selective components replacement: ML, pump-head/raceway, tubing, connector, stopcock/pigtail, AV bridge ⚙️ post-replacement phase 🛒 bit.ly/ELSObooks

Exploratory laparotomy in #ECMO 🩺 indications? bowel pneumatosis, portal venous gas, free air, mesenteric edema, distention + rapid Hb decrease, increasing vasopressors or ventilatory pressure 🩸 most ischemic injuries? watershed hypoperfusion due to CS or ECMO: thromboembolism rare 🔗 bit.ly/4alLSvB

Homemade #ECMO cannulation model for simulation training ♻️ customizable low cost phantom: agar-agar, household materials, repurposed medical components 🖥️ enables #POCUS guided access, cannula insertion, EBF initiation; can be easily integrated in mannequins @asaiojournal.bsky.social 🔓 bit.ly/4al18ZC

RBC transfusion decision making in non bleeding critically ill 🩸 DO2/VO2 + adaptation mechanisms to Hb drop 🩸 should RBC transfusion be not only Hb based? 🩺 evidence supporting use of physiological triggers: ScvO2, A-V O2 difference, O2ER, lactate, troponin, tissue perfusion, PbtO2 🔓 rdcu.be/e31QP

🎥 Recordings of joint EuroELSO & SEMICYUC webinar: #ECMO in Out-of-Hospital Cardiac Arrest: a matter of time and details in NOW available open access 🔓 www.youtube.com/watch?v=egV63igN41g 🚁 Organization & patient selection: Dutch HEMS experience 🩺 Practical aspects of cannulation/initial management

Driving vs transpulmonary pressure? 🫁 ΔP = Pplat - total PEEP 🫁 PL = Paw - Ppl (Ppl approximated by Pes) 🗝️ key advantage of PL? allows to distinguish lung vs chest wall mechanics ΔP enables individualization of VT according to size of baby lung; PL allows to titrate PEEP #FOAMcc 🔓 rdcu.be/e3TSf

Just over a week to go until our next BTPT webinar! Make sure you sign up now to secure your space - tinyurl.com/liverkidneyt...

🎥 Celebration of Dr Bartlett is live youtube.com/@TheELSO 1️⃣ Welcome 2️⃣ Renaissance man 3️⃣ The Clinician 4️⃣ Clinical researcher & inventor 5️⃣ ECMO origins 6️⃣ Maturation of ECMO 7️⃣ ELSO - Bob's vision for a global #ECMO community 8️⃣ The patients' view 9️⃣ Lessons from Bob 1️⃣0️⃣ Closing remarks 1️⃣1️⃣ Music program

🩸 Noninvasive approach for real-time detection of thrombi in #ECMO circuits using acoustic measurements, not requiring any modifications. This technique may be used to develop a system to warn of potential clots, to be coupled with clinical observations. @asaiojournal.bsky.social 🔓 bit.ly/4at1snM

Prone positioning in VV #ECMO?? no net physiological benefit after #ECLS initiation in this animal model 🐖 with severe #ARDS randomized after VV initiation to prone or supine positioning for 48 h, receiving an ultraprotective MV strategy 🫁 Open access #FOAMcc #FOAMecmo 🔓 rdcu.be/e28tP

(Circuit) integration or separation approach in #ECMO patients requiring #CRRT? E-CRRT RCT 🔎 80 pts allocated to circuits integration vs separation ⚖️ no significant difference in filter lifespan 🪦 comparable mortality 🫧 no differences in serious adverse events including air embolism 🔓 rdcu.be/e2FyX

📖 Monitoring #extracorporeal circuit and pt on #ECLS: Blue Book, chapter 12 🖥️ circuit: pressures, EBF meters, air/bubble detectors, OxyHb monitoring, temperature 🖥️ patient: arterial BP, SpO2, Sc/SVO2, rSO2, EtCO2, PAC, #POCUS, neuromonitoring 📘 the #ECMO Specialist Training Manual 🛒 bit.ly/ELSObooks

VA #ECMO related axillary artery cannulation & aortic hemodynamics ☢️ insights from computational fluid dynamics models derived from 10 CT-based geometries to simulate flow via right or left axillary artery access under varying levels of cardiac dysfunction @asaiojournal.bsky.social 🖇️ bit.ly/3OkAPKd

📢 #ECMO in OHCA: a matter of time and details, joint webinar EuroELSO & @semicyuc.bsky.social 🚁 Organization and patient selection: Dutch HEMS experience 🩺 Cannulation and initial management 🎤 Q/A 📆 Feb 10 2026, 15:30 CET Register 🖋 www.euroelso.net/webinars/ Lectures in 🇬🇧 Q/A translated in 🇪🇸

Invasive ABP? True monitoring tool 🎯 accurate interpretation 🫀 physiological insights: aortic pressure, arterial compliance, reflection waves, peripheral BP 🩺 applications & targets: MAP/organ perfusion, PP/DV, DBP/vascular tone, SBP/LV afterload 🌊 PPV & fluid responsiveness #FOAMcc 🔓 bit.ly/3LJYsva

🍽️ 2025 ELSO Consensus statement for provision & management of nutrition therapy in critically ill adult patients requiring #ECMO @asaiojournal.bsky.social 🔓 bit.ly/45BLRkq

📖 Priming the #ECMO circuit 💧 pre-priming: rationale 📦 considerations, storage, management 💧crystalloid prime procedure 💧fluid selection: NS vs balanced crystalloid solutions 🩸blood prime: steps & considerations The chapter includes online files for download (checklists + editable labels)... Enjoy

The ELSO Registry Data Quality and Integrity Program. The Registry is used by various stakeholders to 🥅 improve patient & institutional care quality 📊 support research 📦 support device regulation, 🖥️ monitor practice patterns 📰 share best practices. @asaiojournal.bsky.social 🔓 bit.ly/4k9e9IX

Ultrasound in #ECMO? #POCUS ubiquitous & indispensable in the care of #ECLS patients, from indication to choice of configuration, cannulation, monitoring, weaning and post decannulation. @asaiojournal.bsky.social #FOAMcc #FOAMecmo #FOAMus #echofirst 🔓 bit.ly/4bUMDN6

The January #ISHLTJournalWatch focuses on topics in #transplant #pharmacy, edited by Colleen Hutchinson. 💊 Topics include the NUDT16 genotype, #daratumumab monotherapy, & early mammalian target of rapamycin inhibitor (#mTORi). 🔗 www.ishlt.org/about/news-d... #TransplantSky #PharmSky

Ultrafiltration in critically ill 🩺 physiological effects & response to UF 🖥️ monitoring & guidance 💦 UF intolerance 🫀 intolerance endotypes: preload dependence, cardiac dysfunction, ⬇️ vascular tone, autonomic dysfunction, ⬇️ vascular refill 🪡🧵 rationale & step towards personalized UF 🔓 rdcu.be/e0XBg

🎤 The celebration of the life and legacy of Dr. Robert H. Bartlett is ongoing at Hill Auditorium in Ann Arbor, MI. We are honouring the Father of #ECMO with a day of talks and tributes given by Bob's colleagues, peers, friends, family. We are uploading a photo book on our Fb page 📸 bit.ly/3NDUDrU

Pharmacologic & toxicologic confounders in brain death determination 🧠 coma 🧠 BD & death by neurologic criteria 💉 controversies in existing BD declaration guidelines 🚧 PK & PD challenges: hypothermia, organ failure, obesity, prolonged infusions, toxicokinetics 🛟 ancillary testing 🔓 rdcu.be/e0C9u

Conversion from VV to VA or hybrid #ECMO configuration in patients treated for refractory respiratory failure developing refractory hypoxemia or hemodynamic compromise? Higher mortality/complications rate. Initial configuration selection pivotal! @critcaremed.bsky.social 🔗 bit.ly/4pT9Na1

🎞️ Recordings of our recent webinar: ELSO Registry Tips & Tricks to Data Entry, is now available for anyone interested for everyone in the #ECMO community who wants to improve their expertise in navigating into Registry tools & optimize data entry. Open access #FOAMcc #FOAMecmo 🎥 youtu.be/VasZ-Oa7EKM

Preoperative #ECMO in children with dextro-transposition of the great arteries undergoing arterial switch operation ⚖️ 70% ASO on ECMO: more complications/higher mortality (61%) vs preop weaning If possible preASO ECLS weaning may improve outcome? @pedcritcaremed.bsky.social #PedsICU 🔗 bit.ly/4bCrU0n

🎓 Education & surgical training in cardio-thoracic #transplantation webinar 🚧 Challenges How I do... 🫀heart #transplant 🫁 lung Tx 🫀🫁 heart-lung Tx ❓Q/A 📆 February 5, 2026 ⏰ 18:00-19:00 CET Register at 🔗 bit.ly/3NrmEmr 🖥️ organized by @esottransplant.bsky.social ECTTA and Education Committee

🖥️ ELSO Registry: Tips & Tricks to Data Entry Webinar. @theelso.bsky.social will host a webinar on tips and tricks for data entry, featuring experts from different centers. Presenters: Save the date! 📆 January 21, 2026 ⏰ 11:00-12:00 AM US Eastern Time Register NOW 🔗 bit.ly/RegistryWebi...

VenoPulmonary #ECLS: current use across different clinical conditions, adverse events, outcomes, prognostic drivers: 🫀🫁 VP #ECMO chiefly used for HF/CS (54.4%) and ARF/ARDS (26.6%): hospital outcomes, complications and survival differed according to diagnosis leading to VP ECLS 🔗 bit.ly/4pKMHSS

Alveolar gas equation and its clinical implications 🧮 derivation & application of AGE 💨 fraction of inspired oxygen 💨 atmospheric pressure 🩸PaCO2 & respiratory exchange ratio 🫁 alveolar O2 partial pressure & A–a gradient in the approach of hypoxemia and pulmonary shunt #FOAMcc 🔓 rdcu.be/eZtD8

Death by neurologic criteria in neonates undergoing #ECMO 🔍 @theelso.bsky.social Registry Study, 2010–2023, including about 15K neonates (≤28 days old, born after 37 weeks gestation) on #ECLS 🪦 DNC rarely diagnosed: 0.5% neonates ⏱️ 84% DNC diagnoses occurred after 24 hours of run 🔓 bit.ly/49zx4sV

Death by neurologic criteria in neonates undergoing #ECMO 🪦 DNC rare: 0.5%, 2% of overall mortality ⚖️ factors associated w greater risk pre-ECMO CA, severe acidosis, cardiac support/central cannulation, hyperoxemia Optimizing #ECLS management pivotal! @pedcritcaremed.bsky.social 🔓 bit.ly/49zx4sV

SAVECMO study, consensus on key aspects of cannula-site infections in peripheral #ECMO: 🔍 Delphi study involving 39 international #ECLS experts definition 🩺 suspicion & methodology for diagnosis 🧫 bacteriology 💉 treatment & treatment failure ⚠️ preventive measures #FOAMcc #FOAMecmo 🔗 rdcu.be/eZd0g

🎓 Adult #cannulation workshop including #POCUS guidance, with a team of international experts. Three 1 day hands-on sessions to learn percutaneous ECMO cannulation (VV, VA, bi-caval) 📆 April 18 📆 April 19 📆 April 20 🆕 📌 Ann Arbor MI Register at 🎓 bit.ly/ELSOAcademy Info 📬 [email protected]

Start 2026 with #ECLS education and/or training? 🎓 Adult ECMO #simulation course on VA & VV ECMO, through hands on learning and troubleshooting scenarios of clinical cases. Two 1 ½ day sessions 📆 April 14-15 📆 April 16-17 📌 Ann Arbor MI Register at 🎓 bit.ly/ELSOAcademy Info 📬 [email protected]

📖 The membrane lung Chapter 9 of 📘 The Blue Book is focused on this essential component of the #ECMO circuit 🫁role 💨 how gas exchange takes place: oxygenation, CO2 removal & how to improve these ⚖️ selecting appropriate ML 🩸thrombosis 🔍 monitoring 🛒 bit.ly/ELSObooks