Chat Log C:\Users\Bagus Ronidipta P\Documents\ChatLog DIGITAL

ECMO WEST DAY 1 2021_02_09 02_16.rtf

Sokol Shehu (to Everyone): 23:06: strange sound

Sokol Shehu (to Everyone): 23:07: better
Maria Trêpa (to Everyone): 23:09: sound problem..
Marta Cucchi (to Everyone): 23:09: there is a recurrent disturbing sound.
it’s hard to follow the lecture.
Katherine Jacoby (to Everyone): 23:10: feedback recurring multiple times
makes it unable to hear.
LYNN FEDORUK 2 (to Everyone): 23:10: everyone needs to be muted and
as well only on one device
Lyndal Russell (to Everyone): 23:10: If everyone turns off their mic, the
sound problem should not occur
Jose Cuevas (to Everyone): 23:20: Are there any trials or established
protocols for proning + VV ECMO?
Maria Trêpa (to Everyone): 23:21: What is your opinion on putting young
patients on ECMO that have been on MV for > 7 days?
Katherine Jacoby (to Everyone): 23:21: How do you prepare families /
discuss ECMO treatment, set expectations, etc
Sokol Shehu (to Everyone): 23:21: how do you decidde when to prone vv
on ecmo
Divina Tuazon (to Everyone): 23:21: Any complications while proning pts
while on ECMO?
Sokol Shehu (to Everyone): 23:21: on vv ecmo
Salman Butt (to Everyone): 23:22: any complications you have faced while
proning patients post ECMO? Cannulation, circuits etc
Marta Cucchi (to Everyone): 23:23: Are there any awake-ECMO strategy in
place for ARDS patients to improve early mobilisation and MV weaning?
Divina Tuazon (to Everyone): 23:23: what if appropriate age limit for
exclusion criteria
Roshith Chandran (to Everyone): 23:24: How long will you continue on VV
ECMO, if the patient is not improving? iIn absence of other complications
Hiroyuki Tanaka (to Everyone): 23:25: do you have withholding or
withdrawing from long duration ECMO criteria?
Marta Cucchi (to Everyone): 23:25: Do you use any specific score to assess
progression of long term ECMO? trying to standardise the practice?
Divina Tuazon (to Everyone): 23:44: Woud it better to liberate from the
MV after ECMO? But how about de-recruitment?
Atiyeh Tajik Roostami (to Everyone): 23:44: which mode of ventilator is
beter than for ECMO patient
Bohman, John K. (J. Kyle), M.D. (to Everyone): 23:45: Recommendations
for monitoring for P-SILI post-extubation?
Jose Cuevas (to Everyone): 23:46: What is your experience with APRV as
opposed to VC/PC? any reason why you might prefer one over the other?
Marta Cucchi (to Everyone): 23:48: Opinion on Awake-ECMO?
Mostafa Eladawy (to Everyone): 23:49: what cannulation you use for
Awake ECMO?
Roshith Chandran (to Everyone): 23:50: Patients who have very low
compliance, with difficult mechanical ventilation, does extubation and
leaving them non ventilated considered an acceptable strategy?
Katherine Jacoby (to Everyone): 0:08: Do you use the Do2/Vo2 ratio or
other perfusion parameters to tolerate hypoxemia ?
Divina Tuazon (to Everyone): 0:09: How often do you add another
cannula to improve oxygenation?
Kartik Ramakrishna (to Everyone): 0:09: Do you have a weight/size cut off
for considerig ECMO?
Mostafa Eladawy (to Everyone): 0:10: what PO2 range do you accept on
VV ECMO?
Hiroyuki Tanaka (to Everyone): 0:11: we use 24 Fr for drainage, and 20 fr
for return, is it too small?
Roshith Chandran (to Everyone): 0:11: Is using muscle relaxants and
cooling the patient to reduce O2 requirement considered an acceptable
strategy to optimise O2 demand supply ratio?
Thomas Scheller (to Everyone): 0:14: Do you puncture the femoral vein
(or arteria in VA ECMO) above oder below the lig inguinale
Alexander Finch (to Everyone): 0:22: re: out of hospital cardiac arrest, do
you have a stardardized criteria for cannulation in this data set?
user (to Everyone): 0:30: how do you manage pulmonary oedema under
ecmo
Alexander Finch (to Everyone): 0:31: thank you!
Katherine Jacoby (to Everyone): 0:32: In whom would you try impella or
IABP first?
Maria Trêpa (to Everyone): 0:32: do you use the swan-ganz in unclear
cases to decide?
Salman Butt (to Everyone): 0:32: what do you use to vent and prevent
distention during VA/
Maria Trêpa (to Everyone): 0:33: Do you routinely go for IABP to unload
the VE? or just in selected cases?
Maria Trêpa (to Everyone): 0:34: great answer, thanks
Maria Trêpa (to Everyone): 0:39: Regarding the swan: In the original
definition of ARDS, high PAOP was included. And in both CS and ARDS we
can expect high PSAP and RVP. How do you swan to distinguish between
“cardiac” edema (from high LVEDP) and “pure” ARDS - what parameters do
you use?

Maria Trêpa (to Everyone): 0:39: PAOP=PCWP

Salman Butt (to Everyone): 0:58: what is the average cost of a mobile
ECMO?
Sokol Shehu (to Everyone): 0:58: what about tunnelization of cannulas
and implantation under direct vision, less com?plications
Salman Butt (to Everyone): 1:00: Thanks
Claudia Marcela Poveda Henao (to Everyone): 1:00: When the arteries
are very small or present vascular complications , do you perform mix
central aorta cannulation or convert to all central managament?
Alexander Finch (to Everyone): 1:01: Is there a preference of the angle of
approach of the needle for percutaneous access under ultrasound
guidance?
Alexander Finch (to Everyone): 1:02: thank you!
Roberto Pablo Martínez Rubio (to Everyone): 1:02: Do you perform
atrioseptostomy in order to unload the left ventricle?
Katherine Jacoby (to Everyone): 1:21: Can you comment on ecmo for
sepsis distributive shock patients.
Atiyeh Tajik Roostami (to Everyone): 1:21: we use mirlinoon more than
dubotamin in low EF patient ٫which one is better for ECMO?
Jose Cuevas (to Everyone): 1:23: Do you have a system in place for
identification of the patients that would be candidates or this left at the
discretion of clinicians?
Seyedmohammad (to Everyone): 1:23: after Arterial switch we use atrial
pacing
Claudia Marcela Poveda Henao (to Everyone): 1:23: Do you have
experience with cytosorb plus ECMO in septic shock?
Alexander Finch (to Everyone): 1:24: For bacteremic patients, was there
any concern for colonization on the cannulas or need for replacement of
the cannulas?
Seyedmohammad (to Everyone): 1:24: what is your recommendation
about induction sinus tachycardia on ECMO in LCOS after Arterial switch?
FERNANDO LIMA DOS SANTOS (to Everyone): 1:25: Good afternon!
What is the best intervention for insufficient drainage due to
the formation of a thrombus in the venous catheter the ECMO?
Mostafa Eladawy (to Everyone): 1:40: how frequently you monitor anti Xa
on ECMO?
Seyedmohammad (to Everyone): 1:41: what’s your experience with
novoseven on ECMO?
Raul Neto (to Everyone): 1:41: You mentioned those targets for regular
patients, but not for COVID 19... COnsidering the protrombotic and pro
inflamatory profile of COVI19 patients, do you adjust your targets for
anticoagulation on Ecmo?
Jose Cuevas (to Everyone): 1:41: I may have missed this but has COVID
changed your anticoagulation protocol?
Administrator (to Everyone): 1:42: how frequently you measure aPTT after
initiation of ECMO?

Behzad Sheikhi (to Everyone): 1:43: What about prothamin sulfate on

ECMO?
Kartik Ramakrishna (to Everyone): 1:56: How long do you prone the
paitent for? Do you prone and unprone for multiple days and what guides
that decision? Do you have specific criteria?
Katherine Jacoby (to Everyone): 1:56: Do you turn the head/body for
pressure ulcer issues?
Divina Tuazon (to Everyone): 1:57: How do you prevent pressure sores
from ETT holders and plexopathy during prone positioning?
Administrator (to Everyone): 1:57: Did you have facial edema in prone
position?
saeid Hosseini (to Everyone): 1:58: Is any possibility of face injury in
prone position?
Katherine Jacoby (to Everyone): 1:58: what duration do you leave the
patient prone per day? similar to vent patients? ~16 h
Raul Neto (to Everyone): 1:59: Do you have experience with longer Prone
periods? >24h?
Katherine Jacoby (to Everyone): 2:00: when do you start proning VV ecmo
patients? same day as cannulation, or how do you decide when?
Divina Tuazon (to Everyone): 2:00: do you experience pressure sores
where cannulas are positioned?
Marwan Sadek (to Everyone): 2:06: sever AVR is contraindicated with VA
ECMO ?
Federico Romagnosi (to Everyone): 2:11: how did you manage
anticoagulation on AVC?
Sokol Shehu (to Everyone): 2:12: how do you manage IVC thrombosis?
Federico Romagnosi (to Everyone): 2:13: thank you
Sokol Shehu (to Everyone): 2:13: how did you manage early graft
dysfunction?
saeid Hosseini (to Everyone): 2:14: Merci beaucoup
Sokol Shehu (to Everyone): 2:14: thnx
Francisco Gutierrez Galindo (to Everyone): 2:14: thanks
saeid Hosseini (to Everyone): 2:15: Interesting session
Atiyeh Tajik Roostami (to Everyone): 2:15: tnx
Sokol Shehu (to Everyone): 2:15: great
Jana Ljubas Macek (to Everyone): 2:16: Amazing lectures and discussions!
Administrator (to Everyone): 2:16: Thank you all
Atiyeh Tajik Roostami (to Everyone): 2:16: good job
Raul Neto (to Everyone): 2:16: See you tomorrow