#ARDS in pts with malignancies? Experience high mortality, irrespective of #ECMO. Nuanced ICU goals-of-care discussions needed, as caution when considering #ECLS: general recommendations may not apply to this population #FOAMcc @intenscaremed.bsky.social @schellongowski.bsky.social 🔓 rdcu.be/eI44I

Delighted to present results of my group(s) latest research on normothermic regional perfusion at #ELSO2025 in Washington! 🫘 Regional saturation directed NRP in in #DCDDs (spin off of my PhD project!) 🔓 bit.ly/489UWTC 💨 ML exhaust CO2 monitoring to guide SGF management during #NRP 🔓 bit.ly/489gYWC

#ECPR demonstration at #ELSO2025!! ECPR may improve outcome in refractory CA if 🎓 done with a high #ECLS experience ⚖️ pts are selected well ⏱️ EBF can be initiated fast (<60') Still to be defined ideal location ECMO to pt or pt to #ECMO? 🩺 optimal post-CA care 🚧 complications are recognized timely

Hypoxemia on VV #ECMO? Develop a systematic approach 🚧 quickly rule out (with circuit check + blood gas analysis) things killing the patient rapidly but that you can quickly troubleshoot: extreme recirculation, ML failure and gas supply interruption, drainage insufficiency  #ELSO2025 Zakhary B 🪡🧵1/2

#ECMO circuit anatomy at #ELSO2025! Ideal circuit? Able to meet pt population(s) needs, program needs and available resources. Key component remain the same 🪡 cannulae: initial selection + positioning essential, but post-insertion adjustements and long term monitoring/management pivotal, too 🪡🧵 1/3

#ICU rounds at #ELSO2025! First tricky case: refractory hypoxemia on VV #ECMO... it could be circuit problem or new pt problem. How to optimize the EBF/CO ratio to increase #ECLS support to oxygenation? Options to consider (each w pro-con, some available evidence, sometimes conflicting) See 🪡🧵 1/3

#ELSO2025, the 36th Annual ELSO Conference just started with pre-conference here in Oxon Hill, Maryland, just outside Washington, DC 🖇️ bit.ly/ELSO2025

Finally here in 📄 paper & ink 🖋️!! The 5th #ECMO specialists training manual: the new ELSO Blue Book 📘 Available at #ELSO2025, starting tomorrow!! With all theq ELSO publications: 📕 The ELSO Red Book 6th Edition 📘 Post-cardiotomy #ECLS & other temporary MCS in adults 📕 ECPR and Resuscitative #ECMO

The @theelso.bsky.social ECMO Bedside Guide is now available globally FREE open access for everyone interested in #ECLS! Honoured being among leads for 📋 Checklists & ⚠️ Panic button sections Other topics ⚖️ assess candidacy 📦 equipment 🧮 calculators 💉 medications 📚 resources 📱 bit.ly/ELSOBedsideG...

#ECPR in refractory cardiac arrest in adults: marked variability in reported cost-effectiveness! lEconomic evaluation for appropriate implementation of #ECMO in CA across various healthcare settings remains heterogeneous, highlighting the urgent need for standardised reporting 🔓 bit.ly/46IZmQ1

Get the app for 36th Annual ELSO Conference! We created an app for #ELSO2025! Use it to stay up to date with latest news & announcements, see your personal schedule, create your event profile. 📱Open the App: bit.ly/47MH3KP - 8️⃣ days: We look forward to seeing you in DC! 🗓️ Sep 27-30 🖇️ bit.ly/ELSO2025

📢 Here's the new Blue Book! The #ECMO specialists training manual 5th 📘current best practices & advances in #ECLS for all #ECMOlogists 📘 new chapters, as Priming & End-of-Life Care (including bridge to OD and #NRP) 📘new educational resources, as #simulation training, MCQs + scenario-based questions

Recovering cardiac function through TA #NRP in DCD donors undergoing prolonged no-touch & WIT 🔍 11 HTxs from DCDDs ⏱️ prolonged fWIT 49.5 ± 11.3' 🫀 TA NRP w closed #ECMO circuit allowed function assessment/reconditioning pre procurement & SCS ⚖️ short-term outcomes similar to DBDDs 🖇️ bit.ly/4nwQZfQ

Interested in new devices?? Don't miss technology & innovation session at #ELSO2025 💨 microfluidic MLs 🚨 CARL 🫁 breethe: from pandemic & back ⚖️ optimizing care with #ECMO + another #MCS 🫀 Brio Heart & Brio VAD 🐖 ECMO & ECPella in model of CS 🗓️ Sep 27-30, 2025 📌 Washington, DC 🖇️ bit.ly/ELSO2025

🫀 Outstanding 4ᵗʰ Edition for the Bologna Heart Surgery Symposium! Thanks to the Organizers for inviting me to join the faculty to discuss about the role of a normothermic regional perfusion #NRP team to support DCD organ donation, allowing me to be part of this impressive event! 📸 Here some pics!

How to mitigate adverse hematological effects of #ECMO? 🚧 new strategies should be studied carefully before adoption 🩸 no anticoagulation safe in selected pts (eg VV adults) but unsuitable for other (ie infants) 🔬 better understanding of blood-polymer interface needed, using contemporary techniques

Multiple #ECMO in Congenital Diaphragmatic Hernia? Rate of CDH neonates requiring repeated #ECLS low. Reasonable survival (improving over time) observed when >1 run was offered: if no contraindications, second course should be considered, when required. #FOAMcc #FOAMecmo #PedsICU 🔓 bit.ly/3KlHaTJ

- 1️⃣5️⃣ days to #ELSO2025! Coming to Washington? You don’t want to miss our (early) morning meetings ☕️ Directors Meeting, September 29 7:00-8:00 AM ☕️ Coordinators Meeting, September 29 7:00-8:00 AM Register now! 🗓️ September 27-30, 2025 📌 Oxon Hill, Maryland, outside Washington, DC 🖇️ bit.ly/ELSO2025

Call for manuscripts for #EuroELSO2026 Perfusion Special Issue is OPEN! 📢 issue will focus on current advancements, emerging trends, innovations in extracorporeal devices, perfusion, cardiovascular support, AI technologies 📢 we are seeking case reports/series under topic: #ECPR unexpected survivors!

Cases around the world: #ELSO2025 session on unique indications for #ECMO 🌡️ heatstroke-induced organ failure 🐁 leptospirosis 🍄 blastomycosis ☠️ aluminum poisoning 🪰 cardiorenal failure needing #ECLS & CRRT from insect bite 🧫 disseminated melioidosis 🗓️ Sep 27-30 📌 Washington, DC 🖇️ bit.ly/ELSO2025

Extubation of (selected) neonatal & pediatric #ECMO patients?? Feasible & safe, may avoid VILI, decrease neurosedative exposure, improve rehabilitation! 🔍 experience thoroughly describing practices, reporting data on resp support, airway clearance, sedation, #ICURehab #PedsICU 🔗 bit.ly/4mzTkqo

📢 Still time to register to EuroELSO @escmid.bsky.social webinar: ECMO & infectious disease: an interdependent relationship 🗓️ TOMORROW Sep 5, 13:30 CEST 🧫 nosocomial infections in patients receiving #ECMO: device attribution & broad-spectrum ABTs 🧫 #ECLS in septic shock 🖋 www.euroelso.net/webinars/

Interested in #extracorporeal support in respiratory failure?? We are going to have many dedicated sessions at #ELSO2025 🫁 Register for the conference: 🖇️ bit.ly/ELSO2025

Pediatric #ECPR? Complex, resource-intensive intervention impacted by expertise, pt selection, CA characteristics, #ECMO care. Several variables may be useful in determining candidacy; early intervention + individualized post #resuscitation care pivotal. @resuscitation.bsky.social 🖇️ bit.ly/4mJe3Ik

🫘 How to manage renal failure and renal replacement therapy during #ECLS?? Participate in this #ELSO2025 session to learn about the state of the art about #ECMO and critical care nephrology: #AKI, fluid overload & #RRT... 🖇️ bit.ly/ELSO2025

How to use #ultrasound to support clinical decisions on fluid administration in critical ill?? #POCUS to assess 🌵 signs of overt hypovolemia 🫀 signs of critical cardiac conditions 🫁 signs of pulmonary/systemic congestion 💦 expected efficacy of fluid bolus #echofirst #FOAMus #FOAMcc 🔓 rdcu.be/eDftR

- 4️⃣ weeks to #ELSO2025: Start planning your meeting! Interested in research? Don't miss abstracts sessions: 🍼 neonatal #ECMO 🧸 pediatric #ECLS 🫁 🫀adult resp/non cardiac/cardiac 🔬 basic science 🚑 transport 📦 circuit/equipment 🗺️ program development 🗓️ September 27-30 📌 Washington, DC 🖇️ bit.ly/ELSO2025

#ISHLT recently released a statement developed by members in #transplantation, #infectiousdiseases, and #pediatrics regarding the role of #vaccines in protecting the health and survival of heart and lung transplant candidates and recipients. 💉➡️📝 Read the full statement: 🔗 bit.ly/4mJcABW

May membrane lung outlet design increase thrombogenicity?? 🩸 Avoiding auxiliary objects protruding into bloodstream advisable, when designing membrane lungs, to reduce the risk of blood trauma and coagulation activation. #FOAMcc #FOAMecmo 🔓 bit.ly/41PcPDh

Report of pig-to-human ­#Tx 🐖 genetically engineered xenograft into brain-dead recipient 🫁 lung maintained viability/functionality over 216h w/o hyperacute rejection/infection 💦 early severe edema resembling PGD: IRI? 🔬Ab-mediated rejection appeared to contribute to postop damage 🖇️ bit.ly/45zLI1c

Going for VA #ECMO w axillary/subclavian arterial cannulation to avoid retrograde blood flow?? Check arch first! With most common arch type EBF could be directed toward LV! ☢️ >1.2K CT scans analyzed ⚖️ ∼70% ➡️ type III arch: unfavourable scenario may occur if VA #ECMO RAxA/RSA return 🔗 bit.ly/41rVhN7

Cardiogenic shock 📋 definition 🖥️ identification/monitoring 🩺 phenotypes/risk stratification 🔬 biomarkers 🩸 temporary support: #ECMO, Impella, IABP ❤️‍🩹 from dysfunction to recovery 🔭 multi-organ dynamics & inflammation 🔍 non-classic/mixed shock 🫀 RV dominant CS 🫀 infarct complications 🔓 rdcu.be/eCsae

⚡️ #ECPR use increased from 2013 to 2023 with decreasing incidence of seizures: underreporting? evolving EEG practices?? Early detection by cEEG + treatment of underlying risk factors may be important in this high-risk population. 🔗 bit.ly/3HG88oo

#ECMO driven advances in 🫁🫀#transplantation @theelso.bsky.social & @ishlt.bsky.social session at #ELSO2025! 🚑 #ECPR to organ donation 🧠 brain death in #ECLS 🫁🫀DCD for pediatric recipients ⚙️ #NRP & machine perfusion in cardiothoracic #Tx ⚖️ ethical dilemmas of #ECLS, DCD, NRP 🎤 open discussion

#ELSO2025 day 2 will open with an amazing plenary session: take a look at the program & register! 🖇️ bit.ly/ELSO2025

Flexible & multidisciplinary model for ECMO delivery are safe! Results os this study reinforce @sccmcriticalcare.bsky.social & @theelso.bsky.social guidance & support feasibility of expanding intensivist roles in appropriately structured programs. 🖇️ bit.ly/3HK7FS0

Optimal transfusion threshold for VA #ECMO 🔍 OBLEX study: 12 centres in 🇦🇺🇪🇺🇺🇸 ⚖️ emulated target trial: liberal transfusion at Hb ≥ 9 g/dL vs restrictive practice ≤7g 🪦46% mortality 🩸liberal practice? modest survival advantage within first 2 #ECLS days; no apparent benefit beyond day 3 🔓 rdcu.be/eBqR2

Do you want to know more about #ECMO anatomy & physiology?? Ask your perfusionist... or join this #ELSO2025 Pre-Conference session! 🖇️ bit.ly/ELSO2025

Optimal management strategy for adults undergoing VA #ECMO for cardiogenic shock? 🩸💨 🫁 Early implementing a standardized physiologic bundle: MAP > 65 mmHg, balanced oxygenation, limited PaCO2 reduction, lung-protective ventilation has the potential to improve outcome 🖇️ bit.ly/4fHO01H

#ECLS cannula selection? Crucial to enhance performance & hemoprotection! ⚖️ small cannulas led to ⬆️ resistances requiring ⬆️ speeds/⬆️ hemolysis; pump-induced hemolysis could be ⬇️ w larger cannulas, due to ⬇️ pressure losses/⬇️ speeds 🩸 with appropriate cannulas comparable blood damage 🖇️ bit.ly/45lOAP7

#ECMO cannula dressing & cannula/tubing securement: 🔍 point prevalence study describing current practices in 11 centres across 🇦🇺 & 🇳🇿 Lack of specific evidence base guidelines results in variable practices across ICUs, and low adherence to local policies. #FOAMcc #FOANed #FOAMecmo 🔓 bit.ly/45RvY9I

My team got 2 abstracts accepted for #ELSO2025! 🫘🧠 RSO2 directed NRP in DCDDs 💨 ML exhaust CO2 guided SGF during NRP Delighted to see #NRP/DCD organ donation more & more included in ELSO conference program (see #transplant session joint w @ishlt.bsky.social ) + represented at abstract submission!

Submit an abstract to #ISHLT2026! 📝 Abstracts are being accepted in the following areas: ▶️ Research Abstracts ▶️ Early Career Clinical Case Reports ▶️ Late-Breaking Clinical Science Is your science ready? Get started at 🔗 https://bit.ly/4dLYGdn

📢 ECMO & infectious disease: interdependent relationship EuroELSO & @escmid.bsky.social webinar 🗓️ Sep 5, 13:30 CEST 🧫 nosocomial infections in #ECMO: device attribution & ABTs 🧫 #ECLS in septic shock 🖋 www.euroelso.net/webinars/ 🎥 Previous webinars: 🔓 bit.ly/EuroELSOyout... Pic 📘 bit.ly/3HqMoKJ

Hyperoxemia & end-organ complications in VA #ECMO for CS 🪦higher mortality if severe/mild hyperoxemia vs normoxemia 🚧 effect of severe hyperoxemia mostly mediated through direct effect of excess O2 (86%); but it also mediates mortality via neuro, liver, renal, bleeding complications 🔗 bit.ly/4owkqjy

🩸Thrombocytopenia in VV #ECMO? Highly prevalent in VV ECMO patients, and strongly associated with bleeding risk and reduced survival. Platelet transfusions do not appear to significantly reduce bleeding risk: targeted prevention strategies needed! Open access #FOAMcc #FOAMecmo 🔓 rdcu.be/ez2mh

#ECLS for adults with #ARDS ⚙️ technical aspects 📚 evidence for VV #ECMO & #ECCO2R 🫁 indications & timing 🩺 clinical management 🚦special considerations 🏥 centre volume, logistics, hospital networks 🗺️ ECMO in respiratory pandemics 🔗 liberation from ECMO & outcomes 🔮 future research 🔓 rdcu.be/ezDWp

Aortic balloon occlusion through the axillary artery in cDCD donors undergoing A-NRP: how (& when/why)? 🎈EBOA inserted through AxA can safely/effectively regionalize blood flow ⚖️ invasiveness, effectiveness, resources equivalent to femoral approach Here detailed technique. #FOAMcc 🔓 bit.ly/EBOAAxA