Priya Bhaskar, M.D. is an Associate Professor of Pediatrics at UT Southwestern and an attending in the Cardiac ICU at Children’s Medical Center Dallas. She completed her pediatric residency at Inova Children’s Hospital in Virginia and critical care fellowship at UTSW prior to completing a 1 year CICU fellowship at Laurie Children’s in Chicago. Prior to her current position here at UTSW she was a cardiac intensivist at Arkansas Children’s Hospital. Her professional interests include extracorporeal support and education. She serves on the ECMO team as a core staff physician, and she has co-authored a review on this topic that we will use to guide our conversation. 

Learning Objectives:

By the end of this podcast, listeners should be able to discuss:

1. The general indications for VA-ECMO in pediatrics.
2. The anatomic and physiologic rationale supporting various VA-ECMO cannulation strategies.
3. Physiologic targets to ensure adequate oxygen delivery for patients on VA-ECMO.
4. Hemodynamic complications of VA-ECMO such as left atrial hypertension and harlequin syndrome and general strategies in their management. 
5. Liberation strategies for VA-ECMO either to decannulation or conversion to ventricular assist device.

References:

Bhaskar, P., Davila, S., Hoskote, A., & Thiagarajan, R. (2021). Use of ECMO for Cardiogenic Shock in Pediatric Population. Journal of clinical medicine, 10(8), 1573. https://doi.org/10.3390/jcm10081573

Brown G, Moynihan KM, Deatrick KB, Hoskote A, Sandhu HS, Aganga D, Deshpande SR, Menon AP, Rozen T, Raman L, Alexander PMA. Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failure. ASAIO J. 2021 May 1;67(5):463-475. doi: 10.1097/MAT.0000000000001431. Erratum in: ASAIO J. 2022 Jul 1;68(7):e129. PMID: 33788796.

Xie A, Forrest P, Loforte A. Left ventricular decompression in veno-arterial extracorporeal membrane oxygenation. Ann Cardiothorac Surg. 2019 Jan;8(1):9-18. doi: 10.21037/acs.2018.11.07. PMID: 30854308; PMCID: PMC6379183. 

https://www.elso.org/ecmo-resources/elso-ecmo-guidelines.aspx 

https://www.congenitalheartacademy.com/home 

Questions, comments or feedback? Please send us a message at this link (leave email address if you would like us to relpy) Thanks! -Alice & Zac

Support the show

How to support PedsCrit:
Please complete our Listener Feedback Survey
Please rate and review on Spotify and Apple Podcasts!
Donations are appreciated @PedsCrit on Venmo , you can also support us by becoming a patron on Patreon. 100% of funds go to supporting the show.

Please remember that all content during this episode is intended for educational and entertainment purposes only. It should not be used as medical advice. The views expressed during this episode by hosts and our guests are their own and do not reflect the official position of their institutions. If you have any comments, suggestions, or feedback-you can email us at [email protected]. You can also check out our website at http://www.pedscrit.com. Thank you for listening to this episode of PedsCrit!