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)

Introduction

  • Focus on physiological changes in pregnancy, ECMO implications, outcomes with VV and VA ECMO, and special considerations in cannulation and management.
  • Case-based approach highlighting real clinical scenarios.

VV ECMO in Pregnancy

Case Study

  • 37-year-old, 23 weeks pregnant, influenza-related ARDS requiring VV ECMO.

Applicability and Outcomes

  • Systematic review (~400 patients, mostly COVID-19 ARDS).
  • Complications:
    • Venous thromboembolism: 17%
    • Cardiac complications: 17%
    • Neurological events (stroke/ICH): 7%
  • Survival:
    • Maternal: 75%
    • Fetal: 83%
  • Conclusion: VV ECMO is feasible and effective in pregnancy.

Physiological Changes and ECMO Implications

  • Respiratory: ↓ colloid osmotic pressure, ↑ tidal volume, compensated respiratory alkalosis.
  • Cardiovascular: ↓ SVR, ↑ CO by ~40%, IVC compression affects cannulation.
  • Renal: ↑ clearance, ↓ creatinine/BUN.
  • Hematology: Hypercoagulable state, gestational thrombocytopenia, ↑ risk of VTE.

Cannulation and Management

  • Ultrasound essential; left tilt for IVC access.
  • Prefer two-site cannulation for higher flows.
  • Ventilation: lung-rest strategy; often need higher PEEP.
  • Anticoagulation: unfractionated heparin preferred.
  • Delivery:
    • <32 weeks → avoid unless obstetric indication.
    • 32 weeks → multidisciplinary decision.
    • Mode (CS vs vaginal) individualized.
  • Fetal Monitoring: after viability; adjust ECMO to optimize placental perfusion.
  • Decannulation: higher DVT risk → Doppler surveillance and therapeutic anticoagulation.

VA ECMO in Peripartum Cardiomyopathy

Case Study

  • 34-year-old with peripartum cardiomyopathy, EF 25%, progressed to cardiogenic shock and multiorgan failure.
  • Managed with VA ECMO + Impella for LV unloading.

Indications

  • Amniotic fluid embolism, peripartum cardiomyopathy, myocarditis, septic cardiogenic shock, PAH, RV failure, severe preeclampsia/eclampsia.

Outcomes

  • Registry data:
    • 72% successfully weaned.
    • 64% discharged alive.
    • Survival in PPCM: 60–73%, higher than non-obstetric populations.
    • ECPR survival in obstetric cases: up to 60–87%, compared to ~30–40% general.

Key Take-Home Messages

  1. VV and VA ECMO are feasible in pregnancy and peripartum with generally favorable maternal and fetal outcomes.
  2. Multidisciplinary team (MDT) input is essential for candidacy, management, and delivery planning.
  3. Physiological changes in pregnancy demand special cannulation, ventilation, and anticoagulation strategies.
  4. Survival outcomes in obstetric patients are better than general populations, including in ECPR.
Saving Lives Academy
Privacy Overview

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.