TA #NRP in cDCD heart donors using closed #ECMO circuit, modified to provide 🩸🌡️effective NRP despite prolonged fWIT 🫀LV venting 🫀 fast conversion to central configuration as needed ⭕️ shunt for recirculation 🫧 air management #FOAMcc @asaiojournal 🔓bit.ly/TANRPasaio TA-NRP using fully mobile, closed #ECLS circuit could be safe strategy to support combined thoracic/abdominal organs recovery also in peripheral centers without cardiac surgery program, contributing to the expansion of DCD programs, increasing availability/quality of grafts, improving recipients’ outcome. @ESOTtransplant @gabriel_oniscu @LuPoten @Unibo @AUSLRomagna

🔄 The countdown starts now! In exactly 𝗼𝗻𝗲 𝘆𝗲𝗮𝗿, the international transplantation community will come together under the theme ‘𝙈𝙚𝙣𝙨 𝙚𝙩 𝙈𝙖𝙘𝙝𝙞𝙣𝙖 – 𝗛𝘂𝗺𝗮𝗻-𝗖𝗲𝗻𝘁𝗿𝗲𝗱 𝗧𝗿𝗮𝗻𝘀𝗽𝗹𝗮𝗻𝘁𝗮𝘁𝗶𝗼𝗻 𝗶𝗻 𝗮𝗻 𝗔𝗜 𝗪𝗼𝗿𝗹𝗱’: 📍 Prague 📅 26-29 Sep 2027 🔗 go.esot.org/c27_home #ESOTcongress #MensEtMachina #PoweredByESOT

Membrane lung dead space in #ECMO: any relationship with functional impairment?? 🔍 pilot study including 27 ECMO circuits from 20 adults with acute respiratory failure. 🧮 ML dead space (MLDS) calculated from ML exhaust CO2 + blood gas measurements, and used to assess ML effectiveness/need for circuit exchange 📦 10 circuits required replacement; replaced circuits showed higher dead space + lower CO2 in ML exhaust gas + membrane lung CO2 removal vs circuits that completed run (with similar oxygenation-related measures/baseline characteristics) MLDS could be associated with conventional ML performance indicators (as resistances), contributing to a better understanding of ML physiology. MLDS thresholds associated with failure to be defined. Open access #FOAMcc #FOAMecmo 🔓 bit.ly/4yUDVqr

The (influential) role of regret in #ECMO candidacy decision-making 🔍 secondary analysis of qualitative semi-structured interview study w #ECLS international clinicians from urban, rural, public, private centers, Sep-Dec 2024 Three themes identified: 1️⃣ clinicians prefer utility-based reasoning: often not possible 2️⃣ regret of omission & commission both influence candidacy decisions 3️⃣ clinicians employ various strategies to minimize past + anticipated regret This may partly explain known inconsistencies in candidacy decisions within centers. @accpchest 🖇️ bit.ly/3TeJ5yt

Back in Bologna for the opening day of 🎓 Learn & Share 2026 @Unibo to present the results of PhD study on in-situ hypothermic oxygenated perfusion & in situ dual portal & aortic #IHOPE in #DCD donors undergoing ANRP. Privileged to be selected among the best third year candidates, had the honor to represent the PhD Program in Cardio-Nefro-Thoracic Sciences. We are almost at the end of this challenging but amazing journey! What next?? 🔮

Beating the clock: time-targeted & individualized CPR to improve survival in selected patients with refractory CA 🎯 who benefits❓ ⏱️ time-dependent biology of survival: when❓ Cannulation-time gradient 🪟 delivering ecpr within the window: where/how❓ Engineering the system 🔮 knowledge gaps and future directions Refractory CA, once considered uniformly fatal, is now survivable for a defined and growing group of patients. Pooled randomized data confirms clinically meaningful survival advantage for #ECMO vs standard ACLS in refractory shockable #OHCA, but neurologically favorable survival steeply falls as low-flow time, with marked deterioration beyond 30-40'. Faster cannulation is associated with survival, and prehospital & hybrid delivery models have demonstrated an increase in access to #ECLS within the therapeutic window. In parallel, individualized selection integrating rhythm, cardiac arrest characteristics, signs of life + physiologic markers refine candidacy beyond rhythm alone, complementing time-targeted delivery. 🖇️ bit.ly/4iF63Jk

📷 Our study on unlocking potential for tissue donation in patients dying after Out-of-Hospital Cardiac Arrest #OHCA presented at #RESUS26 the @ERC_resus congress in Milan. Limiting factor? Not biology, but system design. Half of eligible cases (according to @CNTrapianti criteria) were excluded from donation pathway due to system-level inefficiencies rather than medical contraindication. The primary limiting factors are organisational, highlighting a critical gap between emergency care and transplantation systems. Integrating early identification strategies and coordinated pre-hospital–hospital procurement pathways may substantially increase donor utilisation and better align care with patient and societal needs.

Accessibility to #ECPR pathway for out-of-hospital cardiac arrests in Greater London 🇬🇧?? Still limited! 🗺️ study analyzing 5 years of routinely collected OHCA data from @Ldn_Ambulance 🚑 776 patients identified as eligible for #ECMO eligibility criteria, but only 3% estimated to reach an #ECLS-capable centre during operating hours and within 45' of CA. Often, threshold exceeded before patients ready for transport Timely access to #extracorporeal cardiopulmonary resuscitation essential to improve outcomes in selected patients with refractory #OHCA: developing an effective & equitable system requires multidisciplinary collaboration to ensure access is maximised while preserving the time-sensitive benefits of this intervention. Modifications to operational parameters, particularly extending time thresholds to 60', extending operating hours, broadening pathway activation criteria, and increasing number of receiving centers could substantially increase access. @ResusJournal @Resus_Plus 🖇️ bit.ly/4hlPUGC

Predictors of in-hospital mortality in #ECPR 🔍 retrospective cohort study 🩸median lactate 8.7 mmol/L 🩸median pH 7.23 🪦 in-hospital mortality 62.4%; higher lactate/lower pH at cannulation associated with increased risk (cutpoints respectively 10.85 mmol/L and 7.2). pH demonstrated stronger/more consistent prognostic value. Optimal criteria for patient selection remain poorly understood: ECPR selection should be center-specific, reflecting resources and readiness. However, findings of this study support inclusion of lactate and pH as part of cumulative, multifactorial risk tools to guide risk assessment and decision-making when evaluating candidacy on an individual programmatic basis. 🖇️ bit.ly/3TztcTl

📢 2026 @AATSHQ expert consensus on antithrombotic management of neonates/infants undergoing cardiac interventions: 🩸hemostatic system as result of developmental and disease-specific factors 🩸 antithrombotic/bleeding management during CPB + catheter-based intervention 🫀 shunt-dependent physiology 🚰 conduits/baffles/nonautologous patch material 🫀 coronary procedures 🫀 interventional cardiology procedures: lower/higher risk 🫀 procedural bridging therapy 🩺 CVC prophylaxis and management 🫀 antithrombotic therapy for valve replacement: MVR, AVR, concomitant aspirin therapy 🔮 limitations and future research #PedsICU 🖇️ bit.ly/4gOxuiC Experts' consensus statements are aimed to define the differences in hemostatic systems vs older children/adults and to provide information specific to patients with congenital heart disease on coagulation cascade; testing for congenital, acquired, therapy-related abnormalities; pre/intra/postprocedural management & monitoring of commonly used anticoagulant/antiplatelet agents.

High-risk acute pulmonary embolism?? Veno-arterial #ECLS with early percutaneous or surgical embolectomy may provide a survival benefit over ECMO as stand-alone therapy 🔍 72 patients: #ECMO + embolectomy, ECMO + thrombolysis or ECMO alone ⏱️ similar complications & support time 🫀🫁 embolectomy associated with most favourable short/mid-term outcome: survival to discharge highest after ECMO + embolectomy lowest post ECMO alone Optimal outcomes will likely be achieved through an integrated approach that combines circulatory support with prompt thrombus removal. @asaiojournal 🖇️ bit.ly/4xof6lH

📢 Cowboy cannulation and simulation showdown hands-on activity at #ELSO2026‼️ We are hosting 5 opportunities to compete in adult or neo/peds cannulations and simulations. 2️⃣ teams will go head-to-head during each slot: fastest team to successfully complete the challenge wins We are excited to have you participate: sign up your team of 4️⃣ members (all registered for the conference - try to represent the diversity of professions that make up ECMO care teams) and take a chance: 🤡 have fun with team name: fun theme/play on words encouraged 👚 team swag or matching attire encouraged, dress up your scrubs with Nashville-themed attire (saline will be used, dress accordingly) Giddy-Up and get ready for our hands-on competitions‼️ There will be 5 time slots to participate during 30' scheduled breaks: select a slot that will work best for all team members: 📆 Conference Day 1 - September 29 ⏰ morning break: adult cannulation ⏰ lunch break: neo/peds simulation only ⏰ afternoon break: adult cannulation and #simulation 📆 Conference Day 2 September 30th ⏰ morning break & afternoon break: adult in-house #ECPR More information and sign-up (1️⃣ form per team): 🔗 bit.ly/4iW4kiP 📬 Please reach out to Elsoconference@elso.org with any questions or concerns 📭 Teams will be contacted by September 18th if they are selected to participate

Circuit thrombosis and mechanical failure in children in #ECMO 🔍 analysis of the ELSO Registry, 2020 - 2024 🔎 > 20K pts < 18 years: >21K runs/ >26K circuits 🛠️ circuit failure = complication requiring circuit or component replacement ⚠️ circuit failure common: 19.2% circuits, at least one replacement in 15.3% of runs ⏱️ median time to failure 129.5 hours ⚖️ neonatal age, low weight (< 3 kg,) higher center volume, VA configuration, prior circuit failure associated with increased risk 🪦 failure associated with significantly increased mortality (49% vs 34%), strongest effect in neonates @asaiojournal #PedsICU 🖇️ bit.ly/4hkvYos

Recording of #SEECMO2026 webinar:🩸 Hemolysis in #ECMO⁉️ More than just a laboratory finding. The webinar 🖥️ was focused on one of the most challenging #ECLS complications: why it happens❓How to prevent/manage it❓ Topics & presenters: 🔍 Clinical impact, pathophysiology, biomarkers of hemolysis @DrGilesPeek 🩺 Cannulation strategies, patient management, real-world cases - Chris Harvey ⚙️ Circuit-related causes, troubleshooting, prevention strategies @FOAMecmo The educational session was designed for anyone involved in ECMO care, from newbies to experienced #ECMOlogist: we hope you'll enjoy! Watch it now... & subscribe to the SEECMO channel!! 🎥 bit.ly/3SVydoP Open access #FOAMcc #FOAMecmo

Prolonged ECMO in children with respiratory failure: any likelihood of native lung recovery?? 🔍 ELSO Registry, >1.8K pts, >/=14 days of #ECLS ⏱️ median run 22.5 days; nonlinear association between time & mortality, with increased risk up to 60 days, then plateau 🩺 survival 50%, associated with shorter runs and shorter time from intubation to initiation 🫁 greater risk of death if primary diagnoses of neoplasms/hematologic diseases, pre-ECMO renal support, higher OI, presence of multiple complications Duration of ECMO alone should not be the sole determinant of poor prognosis: other clinical factors and presence of complications are more relevant ! Should prolonged ECMO definition of be set at 28 days?? @CritCareMed 🖇️ bit.ly/4heWBey With editorial on #ECMO duration as predictor of outcome. Only recently we become aware of potential of pulmonary regeneration, If illness is cured and no more damage is done. A chance of recovery after months of #ECLS may be preferable to early lung #transplantation. 🖇️ bit.ly/4cv58HB

Extracorporeal CO2 elimination for acute exacerbation of severe COPD, X-COPD RCT: 🔍 adults with acute hypercapnic respiratory failure due to AE-COPD requiring IMV who failed/ineligible for extubation within 24 hours 🛑 prematurely terminated trial (by sponsor - financial reasons: 18 patients randomized, planned enrollment 192) ECCO₂R-facilitated early extubation using modern device with sufficient CO2 removal capacity may be associated with shorter duration of IMV/NIV. Numerical trends favored ECCO2R across several secondary outcomes (ie fewer infections + better functional outcomes/quality of life). Small sample -> observations are hypothesis-generating. #FOAMcc @Crit_Care 🔓 rdcu.be/1VFntAnk7eFa

Long-term mortality & functional outcomes among adults treated with #ECMO 🔍 SR/MA including 163 studies (RCTs + observational studies) and >78K patients 🪦 long-term mortality post #ECLS remains high and continues to accrue over the long-term, with substantial variation by modality/clinical indication, ranging from 37.2% for VV to 74.4% for #ECPR at 1 year, but heterogeneity between studies remains substantial 📚 functional outcomes (inconsistently) reported only in 23.3% of studies, including >7.8K survivors using CPC, WHODAS 2.0 or mRS, limiting the understanding of functional recovery among survivors Standardized outcome reporting, and greater focus on survivorship and patient-centered outcomes in future research pivotal to better inform long-term prognosis/follow-up, patient selection, and factors that may improve functional recovery after support. @CritCareExplore 🖇️ bit.ly/3SDFuK3