www.asst-pg23.it

L’arresto cardiaco: quando pensare all’ECMO

Dott. Cattaneo SergioUOC Anestesia e Rianimazione Cardiochirurgica

www.asst-pg23.it

L’arresto cardiaco: quando pensare all’ECMO

1. Metodica ECMO

2. Letteratura

3. Protocollo "LOMBARDIA"

4. DCD

5. Stato dell'arte

E.C.M.O.

RespiratorioInsufficienza respiratoria

grave

Cardiaco Shock cardiogeno

ECPRArresto cardiaco

refrattario

E.C.M.O.Respiratorio (V-V) Cardiaco (V-A)

Supporto polmonare Supporto circolatorio e polmonare

Survival rate 9,6%With functional recovery 7,4%

Circulation. 2016;133:2159-2168.

Circulation. 2016;133:2159-2168.

E.C.M.O.

Support of heart or lung function

with mechanical devices which:

• is temporary (days to weeks),

• can be partial or total,

• avoids ongoing iatrogenic injury,

• sustains life while bridging to organ recovery or replacement.

ECMO - Obiettivi

• Obiettivi del supporto ECMO:– Bridge to recovery

– Bridge to transplant

– Bridge to bridge (VAD)

– Bridge to …

Clot Gestione terapiaanticoagulante

Anestesista

Perfusionista

Cardiologo

Cardiochirurgo

www.asst-pg23.it

L’arresto cardiaco: quando pensare all’ECMO

Dott. Cattaneo SergioUOC Anestesia e Rianimazione Cardiochirurgica