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


Update from the K-Hole: Ketamine in the ED

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martes, 20 de diciembre de 2016

VA ECMO in Trauma

SCANCRIT.COM - December 19, 2016 - By Thomas D
"ECMO in multitrauma patients sounds like asking for complexity and lots of oozing blood – but it seems to have potential for actually stabilising the patient’s systems and get better outcome. The short version: ECMO restores normal physiology and unloads the venous system.
ECMO helps restore normal physiology. ECMO restores cardiac output, thus helps normalise pH and lactate. On ECMO, warming is easy, fighting hypothermia. Correcting acidosis and hypothermia helps correct coagulopathy. The lethal triad works both ways. Running ECMO without systemic heparinisation, using hepaSrin-coated sets, makes this possible.
Heparin can be added later, at a point after you have bleeding control. Also, many trauma ECMO patients only need a quite short run on VA ECMO until they can manage on their own. Hours to a few days.
With appropriate patient selection, ECLS should be regarded as a readily viable rescue therapy for trauma patients."