Level 3: Advanced Course in ECLS/ECMO

Pathway directors:

• Daniel DE BACKER MD, PHD Head of Intensive Care and Emergency Departments, CHIREC Hospitals, Belgium, Professor of Intensive Care Medicine, Université Libre de Bruxelles, Brussels, Belgium
• Leen VERCAEMST RN, ECCP, University Hospital Leuven, Belgium, EBCP-EuroELSO Liaison, Member of the EBCP Scientific Committee & EuroELSO Steering Committee

Directors:

Dieter DAUWE MD, PhD, Cardiologist – Intensivist UZ Leuven, Assistant Professor KU Leuven, Belgium

Jan BĚLOHLÁVEK MD PhD, Cardiologist, intensivist, Chief Physician, 2nd Department of Internal Medicine – Clinic of Cardiology and Angiology, First Faculty of Medicine Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic; Past President of EuroELSO

By the end of this course the participant will be able to understand and explain:

• The indications and challenges of ‘non-standard’ ECMO configurations (V-AV, V-P, high flow configurations, V-A with subclavian return line, …)
• Role of imaging for safe ECMO cannulation and troubleshooting, focus on ultrasound
• ECMO for respiratory support:
  1. Ventilator management and potential role for prone positioning during VV-ECMO support
  2. Management of suboptimal oxygenation during VV-ECMO support
  3. Weaning from VV-ECMO support
• ECCO₂R: Evidence, indications and techniques
• ECMO for adult cardiac failure:
  1. Assessment and treatment of complications secondary to Patient – VA-ECMO
     Interactions:
     1. Focus on left heart congestion and ventriculo-arterial uncoupling: Including extensive discussion on medical and surgical left heart unloading strategies
     2. Other: Differential oxygenation, Limb ischemia
  2. VA-ECMO versus other short-term circulatory support devices (Impella, IABP, …)
  3. Weaning from VA-ECMO support (including echocardiography assessment)
• ECMO for refractory cardiac arrest (ECPR):
  1. Evidence
  2. Indications and contra-indications
  3. Post resuscitation care and neuro prognostication on ECMO
  4. How to organize an ECPR programme?
• The potential circuit complications and how to prevent and/or intervene
  1. Drainage insufficiency
  2. Return obstruction
  3. Air embolism
  4. Pump failure
  5. Membrane lung failure
  6. Gas supply failure
  7. Accidental decannulation and circuit disruption
• Varia: “Capita Selecta” and “Short Topics”:
  1. Procedures on ECMO
  2. Drug pharmacokinetics during ECMO support
  3. Intra and inter hospital Transportation on ECMO
  4. Awake ECMO: Potential benefits and pitfalls (physiotherapy, sedation…)
• Clinical case session will be based on the content of the given talks related to the clinical case. It is the goal for the participant to recognize phenomena and direct the therapy into the optimal direction

1. The ECMO circuit:
   • Indications and challenges of ‘non-standard’ ECMO configurations (V-AV, V-P, high flow configurations, V-A with subclavian return line, …)
2. Cannulation for adult cardiac and respiratory ECMO:
   • Role of imaging for safe ECMO cannulation and troubleshooting, focus on ultrasound
3. ECMO for adult respiratory failure:
   • Ventilator management and potential role for prone positioning during VV-ECMO support
   • Management of suboptimal oxygenation during VV-ECMO support
   • Weaning from VV-ECMO support
4. ECCO2R: Evidence, indications and techniques
5. ECMO for adult cardiac failure:
   • Assessment and treatment of complications secondary to Patient – VA-ECMO Interactions:
     • Focus on left heart congestion and ventriculo-arterial uncoupling: Including extensive discussion on medical and surgical left heart unloading strategies
     • Other: Differential oxygenation, Limb ischemia
   • VA-ECMO versus other short term circulatory support devices (Impella, IABP, …)
   • Weaning from VA-ECMO support (including echocardiography assessment)
6. ECMO for refractory cardiac arrest (ECPR):
   • Evidence
   • Indications and contra-indications
   • Postresuscitation care and neuro prognostification on ECMO
   • How to organize an ECPR program ?
7. Varia: “Capita Selecta” and “Short Topics”:
   • Procedures on ECMO
   • Drug pharmacokinetics during ECMO support
   • Intra and inter hospital Transportation on ECMO
   • Awake ECMO: Potential benefits and pitfalls (physiotherapy, …)
   • Circuit complications

• Senior physicians involved or interested in ECMO
• Perfusionists and Nurses involved in ECMO or interested in respiratory vs circulatory support

ESICM members from the Emerging Nations and Eastern Europe (see list of countries here) are entitled to an discount on registration fees. To qualify, participants must be active ESICM members for the current year. To become a member, please see more information here.

An application will be made to the UEMS EACCME® for CME accreditation of this event.

63 participants from 28 countries integrated their knowledge in ECLS/ECMO in this Advanced Master Course! Here are some of their comments on this innovative educational format and its expected impact on their clinical practice:

• ECLS-ECMO is an evolving field, and master courses may include discussions on the latest research, technological advancements, and clinical guidelines. Staying up-to-date with current trends can help participants integrate the latest evidence-based practice.
• The quality of the presentations. I loved the quiz activity too!
• Prior to attending this lecture, my understanding and grasp of ECMO, as well as its associated physics, were quite limited. However, I have come to realise that my knowledge has significantly improved as a result of this informative session.
• The academic basis followed by interactive real-life clinical cases
• Previously, I had not been able to handle ECMO effectively in my hospital. However, now I am eagerly anticipating the opportunity to work with it.