Course Content
Module 1: Basic ECMO
Module I: Extracorporeal Membrane Oxygenation Basics (ECMO Basics) This module covers the foundational knowledge of ECMO, including circuit physiology, components, and basic ECMO management. Duration: 3 Weeks (Course weeks 1 to 3) Week 1: Introduction to ECMO Week 2: ECMO Physiology & Circuit Management Week 3: ECMO Complications and Troubleshooting Module I Pretest: 30 MCQs
0/20
Module II: Veno-venous Extracorporeal Membrane Oxygenation (VV ECMO)
This module focuses on the use of VV ECMO in patients with respiratory failure. Topics include ARDS management, VV ECMO cannulation strategies, and VV ECMO troubleshooting. Duration: 3 Weeks (Course weeks 4 to 6) Module II Pretest: 30 MCQs Week 4: VV ECMO Fundamentals Start Date: July 20, 2025 a. Respiratory failure and ARDS management (Ahmed Magdey) b. Evidence for VV ECMO use and landmark trials (Hesham Faisal) c. VV ECMO cannulation techniques and pros and cons of different VV ECMO configuration choices (Moustafa Esam) d. ECMO Retrieval and Patient Transport on ECMO (Ahmed Labib)
0/22
Module III: Veno-arterial Extracorporeal Membrane Oxygenation (VA ECMO)
This module focuses on VA ECMO for cardiogenic shock, including cannulation strategies, LV unloading, and advanced applications. Duration: 3 Weeks (Course weeks 7 to 9) Module II Pretest: 30 MCQs
0/19
Extra Corporeal Membrane Oxygenation (ECMO) and Mechanical Circulatory Support (MCS) course (Copy 4)

Future Directions of ECMO — Summary

1. Introduction

  • Perspective: Based on reflection of predictions made in 2019 and ongoing clinical experience since 1994.

  • Core Message: ECMO remains a team-driven therapy where progress must be guided by humility and continuous learning.

2. Historical Context and Early Predictions

  • Past Reflection:

    • ECMO in 1988: limited publications, emerging organization (ELSO), early membrane oxygenators, and challenges with case selection and bleeding.

    • Surface coating improved safety but not eliminated need for anticoagulation.

  • 2019 Outlook:

    • Main barriers identified: late initiation, bleeding, ventilator-induced lung injury, and organizational issues.

    • Still largely true in 2025.

3. Lessons from the COVID-19 Pandemic

  • Unexpected Global Event: ECMO proved critical during COVID-19.

  • Collaborative Networks:

    • ELSO and COVID Critical Care Consortium established guidelines and shared data rapidly.

  • Evidence:

    • Meta-analyses confirmed ECMO’s survival benefit for ARDS and COVID-19.

4. Clinical and Technological Evolution

  • Case Selection & Reversibility:

    • Understanding disease reversibility improved survival (example: long-term ECMO survivors).

    • Gene therapy and new drugs emerging; antibiotic resistance may be mitigated by phage therapy.

  • Advances in Support:

    • ECMO as bridge to recovery or transplant.

    • Transition from heparin to bivalirudin reduced bleeding and neurological complications.

    • Improved survival with single ventricle assist devices.

5. Anticipated Innovations

  • Ventilation & Circuit Control:

    • Vision for reduced or eliminated ventilator use.

    • Future includes wearable respiratory assist devices (“RADs”), automated AI-controlled circuits, and robotic cannulation.

  • Technology Expansion:

    • Broader ECMO deployment in emergency departments, ambulances, and military.

    • Use of xenotransplantation, 3D-printed organs, and microfluidic lungs.

    • Enhanced surface coatings (e.g., tethered liquid fluorocarbon) reducing clotting.

    • Artificial placenta therapy may transform neonatal care.

6. Patient-Centered Practice

  • Awake ECMO:

    • Proven feasible since early experiences; promotes recovery and bridges to transplant.

  • Team Challenges:

    • Need to preserve doctor–patient connection amid growing teams and complex electronic records.

7. Conclusion

  • ECMO’s future combines technological precision with human connection.

  • Awake care, AI integration, and organ innovation will shape the next era.

  • The guiding principle: learn from past challenges while embracing innovation with humility and teamwork.

Saving Lives Academy
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