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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

Calabadions: New Broad-Spectrum Agents to Reverse Neuromuscular Blockade

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sábado, 19 de diciembre de 2015

ECMO

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Mosier J et al. Critical Care 2015, 19:431 doi:10.1186/s13054-015-1155-7
"Conclusion
Since its advent in the 1950s, ECLS has gone from the operating room to a promising rescue modality for cardiopulmonary failure in the ICU and beyond. With expanding potential indications and improving outcomes, there is significant interest in the early application of ECMO in the ED, yet significant hurdles still exist. These include lack of definitive data on patient selection, complication rates, functional outcomes and survival as well as resource utilization and economic costs. The H1N1 pandemic, combined with improvements in general critical care, brought modern and improved ECMO technology into the limelight with good outcomes in the treatment of severe acute respiratory failure. Combined with recent data in patients with cardiac arrest and shock that show promising trends, there appears to be potential for the early application of ECLS to patients in the ED. Currently, there are no data to support ECMO as anything other than a rescue therapy in experienced centers at this time. Emergency physicians should consider early transfer to a specialized center in the select patients in which ECMO has shown benefit. Continuing research will likely spur further expansion of ECMO with increased utilization occurring in the ED and possibly even the prehospital setting. However, we encourage a cautious and evidence-based approach to future applications of ECMO prior to widespread adoption given the logistical and ethical challenges of this technology that has the potential to outpace the supporting data."
http://www.ccforum.com/content/19/1/431

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