UCSF Fresno ECMO

Official twitter account of UCSF Fresno ECMO program.

[UCSF Fresno ECMO @UCSFFresnoECMO]

Greetings, #MedTwitter! This is the official twitter account of UCSF Fresno ECMO program. We will periodically be posting ECMO tweetorials as well as sharing consented &/or de-identified patient stories.

First tweetorial dropping tomorrow morning. Stay tuned!

[UCSF Fresno ECMO @UCSFFresnoECMO]

Cannulation training for the @UCSFFresno PCCM fellows using the new cannulation sim!

[UCSF Fresno ECMO @UCSFFresnoECMO]

https://t.co/WpSNkQdTcp

#ECMOStories

[UCSF Fresno ECMO @UCSFFresnoECMO]

The reason we do what we do!

[UCSF Fresno ECMO @UCSFFresnoECMO]

Every ECLS center has its #ECMOStories

https://t.co/RimAN3nZZT

@MauraWalshEMCCM @civestallman @UCSFFresnoEm @UCSFFresno

[ECLS Virtual Advisors @EcmoAdvisors]

Great thread about determinants of flow in #ECMO.

[UCSF Fresno ECMO @UCSFFresnoECMO]

@Kaminski4Dorian The issue with higher MAP is not just reduced ECMO flows but it also increases the likelihood of the aortic valve not opening - which can be huge problem if you don’t also have an impella (LV & aortic root stasis/thrombosis)

[UCSF Fresno ECMO @UCSFFresnoECMO]

We are back with another tweetorial. In the last one, we talked about the anatomy of the ECLS circuit and the importance of various pressures. This one is all about the flow.

Title: Determinants of ECLS flow: deeper dive
Level: Medium
Author: @thind888

[UCSF Fresno ECMO @UCSFFresnoECMO]

@Kaminski4Dorian That’s actually an excellent question.

If on pressors, usual MAP targets (typically MAP of 65).

If not on pressors, actively avoid higher MAP. I often start vasodilators titrated to 70-75 (personal preference).

[Jonah Rubin MD, FCCP @JonahRubinMD]

Excellent thread on determinants of ECMO flow for both VA and VV!

[UCSF Fresno ECMO @UCSFFresnoECMO]

@JonahRubinMD @vaszochios @iceman_ex @EMinMiami @civestallman @MauraWalshEMCCM @ECMOdaily @EcmoNinja @FOAMecmo @ECMOprincess @ELSOOrg @mtECMO @rbarbosa91 @PBSherren @EduardArgudo @JenelleBadulak @imcrit @ThinkingCC @JoeTonnaMD @MazenOdish @intheICU @kshekar01 @msiuba @MLSCourse

[UCSF Fresno ECMO @UCSFFresnoECMO]

*Factor 6: Miscellaneous*
A mechanical obstruction in any other part of the circuit will ⬇️flows

E.g. clot in cannulae, external compression/clamping of ECMO tubing etc.

If an unexpected drop in flows is encountered, analysis of pressure trends may help identify the cause

/FIN