Jonathan Emling

266 posts

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Jonathan Emling

Jonathan Emling

@JonathanEmling

RN ECMO Coordinator. Interested in all things #shock #ARDS #ECMO & #MCS. Tweets are strictly mine; ideas are mostly stolen from people smarter than me. He/him

Nashville, TN Bergabung Eylül 2021
332 Mengikuti139 Pengikut
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IMCrit
IMCrit@IM_Crit_·
Mixed cardiogenic shock (CS) -herein classified as CS with at least 1 additional contributing cause of shock state- is common (& usually quite challenging to treat...) 20% of all shock patients admitted to contemporary cardiac ICUs have mixed CS Besides this old-school approach
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Philippe Rola
Philippe Rola@ThinkingCC·
Repeat after me: pressure is not flow.
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Holger Thiele
Holger Thiele@thiele_holger·
Congrats to Danger team @CHassager! Impressive results, now after SHOCK and Culprit-Shock 3rd positive RCT. Nevertheless, multiple questions remain: 1) is it the device? 2) patient selection? 3) treatment bias? 4) longer follow-up? @seanvandiepen @JBauersachsMD @NavinKapur4
Sean van Diepen@seanvandiepen

DanGer Shock! The first temporary mechanical support device shown to reduce mortality in patients with cardiogenic shock but there is an increased risk of complications. @ShashankSinhaMD @ShelleyZieroth @JasonKatzMD @thiele_holger @DrDamluji @agtruesdell @Cardio_Girl

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M Velia Antonini
M Velia Antonini@FOAMecmo·
Consider the prognostic importance of age in decisions surrounding initiation of VV #ECMO, even among relatively young patients! Analysis of @ELSOOrg Registry (2017-2022) among adults with acute respiratory failure #FOAMcc on @yourICM 🔓 rdcu.be/dzcdZ Increasing age strongly/independently associated with higher mortality & risk of complications; risk emerges as early as 30 years
Intensive Care Medicine@yourICM

Age & outcomes in adults with acute respiratory failure in VV #ECMO, analysis of @ELSOOrg registry (2017-2022) 🗃️ >27K pts/144 centres 🪦 41.5% in-hospital mortality Increasing age strongly associated with poorer outcomes; risk emerges as early as 30 y 🔓 rdcu.be/dzcdZ

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Ascension Saint Thomas
Ascension Saint Thomas@ascenstthomas·
26-year-old Sydney faced a near-death experience from an infection and kidney stones. Her doctors knew she needed ECMO treatment, so she was transferred to Ascension Saint Thomas Hospital West. This treatment gave her life again, and Sydney continues to praise her care team. 💜
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M Velia Antonini
M Velia Antonini@FOAMecmo·
🩸Modified 4Ts scoring system in patients on mechanical circulatory support?? 4TMCS probability score, considering type of #MCS (IABP, #ECMO, VAD) demonstrated improved diagnostic accuracy vs 4Ts, and higher sensitivity using the guideline-recommended cutoff.
ELSO@ELSOOrg

Modified 4Ts scoring system in patients on mechanical circulatory support which may allow for more accurate screening helping identify patients at risk for developing HIT, with prompt treatment 🖇️ bit.ly/49zYR9p With editorial on MCS & heparin 🖇️ bit.ly/3SAVmZx

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Ascension Saint Thomas
Ascension Saint Thomas@ascenstthomas·
Dr. Yerokun understands that medication for heart failure may not be an option for you. Take a listen as he shares his expertise on alternative treatments that may be right for you. #HeartMonth
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Jonathan Emling
Jonathan Emling@JonathanEmling·
ProtekDuo for the LV 💘 50 pt series of minimally invasive apical ProtekDuo RD cannulation for LV unloading and ambulatory VA #ECMO. 100% survival at 1 yr for patients bridged to 🫀 transplant Viable alternative to #Impella 5.5 in patients with prohibitive arterial anatomy?
M Velia Antonini@FOAMecmo

Novel off-pump direct apical #ECMO cannulation via mini-thoracotomy with dual-lumen cannula @asaiojournal 🖇️ bit.ly/49Iabkf 🫀provides high flow #ECLS with LV decompression + (optional) biventricular + respiratory support 🫀allows ambulation + avoids peripheral artery access-related complications 🫀improves EF, CO/CI & pulmonary artery pressures

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ELSO
ELSO@ELSOOrg·
Direct apical #ECMO cannulation, large single (high-volume) center experience showing that technique could be safe & effective in a selected population at institutions with cardiac surgery support @asaiojournal 🖇️ bit.ly/49Iabkf
M Velia Antonini@FOAMecmo

Novel off-pump direct apical #ECMO cannulation via mini-thoracotomy with dual-lumen cannula @asaiojournal 🖇️ bit.ly/49Iabkf 🫀provides high flow #ECLS with LV decompression + (optional) biventricular + respiratory support 🫀allows ambulation + avoids peripheral artery access-related complications 🫀improves EF, CO/CI & pulmonary artery pressures

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M Velia Antonini
M Velia Antonini@FOAMecmo·
Novel off-pump direct apical #ECMO cannulation via mini-thoracotomy with dual-lumen cannula @asaiojournal 🖇️ bit.ly/49Iabkf 🫀provides high flow #ECLS with LV decompression + (optional) biventricular + respiratory support 🫀allows ambulation + avoids peripheral artery access-related complications 🫀improves EF, CO/CI & pulmonary artery pressures
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Sapna Kudchadkar, MD, PhD
Sapna Kudchadkar, MD, PhD@SapnaKmd·
Thread: My plea for all #ICU staff: 1. Talk to intubated patients, no matter how old or young.Many of your patients are awake, even if their eyes are closed 2. Always tell them what you’re about to do to them and talk to them while you do it. (1/2) #PedsICU #medtwitter #meded
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M Velia Antonini
M Velia Antonini@FOAMecmo·
Left ventricular hemodynamics on VA #ECMO?? Physiology insights from catheterization & 3D echo 🫀 high flow VA #ECLS decompresses LV by significantly ⬇️ LV preload with minimal ⬆️ in afterload 🫀 this ⬇️ LVEDP, LVEDV, LV stroke work, LV PVA #FOAMcc 🔓 bit.ly/47U4Ip5
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Michelle Kittleson MD PhD
Michelle Kittleson MD PhD@MKIttlesonMD·
#TipsForNewDocs Hospitalized patient hasn't walked in days. Wrong: call physical therapy Right: discuss w/bedside nurse if patient stable to mobilize w/nursing staff before calling PT Not every hosp patient needs a PT consult- use this resource wisely. #kittlesonrules
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Jelajahi

@HoustonShockHSS @StavrosDrakos @FilioBillia @CardioNerds @JiwonKimMD @kaznegishi @NavinKapur4 @JDawnAbbott1