Ambulating patients or use of physical therapy while on #ECMO can help improve lung #tranplant outcomes! #ICUrehab @asaiojournal 🖇️ bit.ly/42nwpVU 🫁 90 day waitlist survival highest among non-ECMO group (96%), but after adjusting for median lung allocation score, waitlist survival higher in ambulatory VV vs non ECMO group (86% vs 78%) 🫁 1 year post-LTX survival comparable for patients who can ambulate on VV vs non-ECMO group (88%)

Respiratory #ECMO?? Youth is not always protective! Compared to adult clinicians, pediatric clinicians care for heterogeneous group of patients, with less evidence to help guide/standardize practice as much more difficult to conduct RCTs. They have to adopt a flexible management approach & adapt rapidly to different situations. The approaches of adult and pediatric clinicians have strengths and weaknesses: communication between the two strengthens both and will hopefully spur more research of the optimal management strategies in these vulnerable patients. Editorial 🔓 bit.ly/48jMsG4 Refers to ELSO Registry study including >5K patiens who received respiratory #ECLS (1990 to 2020). Observed mortality higher in teens teens (16-19 y) vs young adults (20-30 y). Difference persisted after adjustment; mechanism underlying finding unclear. 🔓 bit.ly/3NsU3ue Open access #FOAMcc #FOAMecmo #PedsICU on @CritCareMed

Effect of flow & position on lighthouse tip #ECMO return cannula: 🩸tilted cannula reinfused larger amount of fluid through side holes on narrow side vs wide, but fraction of reinfused fluid not influenced by flow rate ratio 🩸small recirculating vortexes developed on narrow side, potentially leading to higher blood damage vs centered case. This effect could be partially mitigated by radial force trying to bring the cannula back toward center Full results free to read #FOAMcc 🔓 rdcu.be/dg0WL

Kidney machine perfusion? preservation + prediction + treatment tool, ⬇️ DGF risk in both DCD/DND donors... Which way forward? 🧊 cold perfusion effective preservation technique NOT for viability assessment best continuous perfusion hubs system most frequently used 🌡️ warm perfusion evidence being generated... unclear if effective preservation strategy continuous or end-ischemic? more suited to assess viability vs cold MP? @ijochmans @ESOTtransplant webinar #ESOTcongress

Accessing #ECMO circuit to provide HD, CRRT & plasmapheresis: how to do it?? Technical report open #FOAMcc #FOAMecmo on @asaiojournal 🔓 bit.ly/3XEYgPd Any thought?? Similar to strategy I consider as best balance between safety/feasibility/effectiveness, but do not like suggested connectors (less complex/safer options exist) + do not agree with sampling blood at top of ML for post-membrane ABG. What do you think?