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
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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)
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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
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Extra Corporeal Membrane Oxygenation (ECMO) and Mechanical Circulatory Support (MCS) course (Copy 4)
  • Scope
    1. 2) Out of hospital cardiac arrest survival: ACLS vs ECPR (data/trials). 3) Inclusion/Exclusion and protocols. 4) Published experiences & prerequisites. 5) Short cases.
  • Key Definitions
    • ECLS: extracorporeal cardiopulmonary life support.
    • ECPR: initiation of ECMO flows during CPR.
    • Sudden cardiac arrest: sudden cessation of blood flow not from terminal stages of another illness.
  • Why beyond ACLS
    • Doing the same (high quality CPR, intubate, epi, bicarb, shocks) → survival did not meaningfully change.
    • Additional tools: resuscitative TEE, beta blockers for VT storm, intra balloon pumps, thoracotomies, ECPR.
  • Evidence Highlights
    • ROC data: wide survival range; day vs night; monitored vs unmonitored.
    • AHA 2021: adult EMS treated non-traumatic out of hospital cardiac arrest survival 1%.
    • PARAMEDIC2: favorable neurological outcome 8%.
    • ARREST (Minnesota): ECPR 43% vs ACLS 7%; CPC ≈ 1; mobile ECMO survival 43%.
    • PRAGUE/INCEPTION: issues (crossover, cannulation, experience); signal toward benefit.
    • Systematic review/meta-analysis: ECPR favored survival and favorable neurological outcomes.
    • Number needed to treat: ECPR 5 vs ACLS 33.
  • Inclusion (core)
    • Age <70, witnessed arrest, no-flow <5 min, low-flow <60 min, initial VT/VF (± selected PEA), EtCO₂ >10.
    • Override: signs of life during CPR.
  • Exclusion
    • Hard: life-limiting comorbidities, no-flow >5 min, significant aortic insufficiency.
    • Soft: low-flow >60 min, pH <6.8, lactate >20.
  • Program Prerequisites
    • Trained EMS, emergency physicians, shock team, rapid ECMO response (surgeons, perfusionist), equipment, experience.
    • Time from arrest to ECPR is critical.
  • Cases
    1. 29-year-old, amniotic fluid embolism, 35 min ECPR → fem-fem VA ECMO 7 days → discharge.
    2. 44-year-old, SCAD in cath lab, 18 min CPR → fem-fem VA → V-AV → VV → decannulated → discharge.
  • Additional survivors after 37–55 min
  • Summary
    • Experience matters.
    • ECPR, if done well and early, saves lives.
Saving Lives Academy
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