EDECMO Podcast

Zack Shinar, MD
  • 4.6 (86)
  • MEDICINE
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EDECMO Podcast

The ED ECMO Project is the work of Zack Shinar and Jon Marinaro to bring extracorporeal life support to EDs and ICUs around the world. This site aims to be the ultimate resource for the background, logistics, and evidence for resuscitative ECMO.

  1. MAR 27

    95: ECPR Organ Procurement with Stephen Wall

    Jon interviews Dr. Stephen Wall from NYU on the podcast where they discuss the need for organs and how ECPR inclusion criteria can significantly impact the problem. Stephen P. Wall, MD MSHS MAEd, is Tenured Associate Professor in the Departments of Emergency Medicine and Population Health, NYU Grossman School of Medicine. Dr Wall was project manager and lead methodologist for the NYC uncontrolled donation after circulatory death (uDCD) program that attempted to increase kidney donation opportunities by considering those who die unexpectedly outside hospitals. Results showed the public was supportive of uDCD, so long as permission is obtained prior to any invasive procedures being performed on the deceased. Lessons learned from the Kidney uDCD program provided justification to attempt in-hospital Lung uDCD in NYC, a project funded by NHLBI (R61/R33HL156890 – PIs Wall and Robert Montgomery, MD PhD). These projects involve cross-disciplinary collaborations with bioethicists, clinical experts from medicine, surgery, emergency medicine, and transplantation, both within and external to hospitals and academic medical centers. Dr. Wall’s research was covered in news media including NPR, NBC, and the Atlantic.

    47 min

  2. FEB 11

    94: Blending Revisited with Aidan Burrell

    In our last episode, Trina Augustin discussed whether we should use a blender in ECPR patients citing the Blender Trial. This month we got the first author of the Blender Trial, Aidan Burrell, to give us insight into the use of blenders for not only ECPR patients but also thoughts on patients on VA for cardiogenic shock and VV patients. Jon Marinaro interviews Aidan for this wonderful addition to this complex decision.   Blender Trial - Burrell A, Ng S, Ottosen K, Bailey M, Buscher H, Fraser J, Udy A, Gattas D, Totaro R, Bellomo R, Forrest P, Martin E, Reid L, Ziegenfuss M, Eastwood G, Higgins A, Hodgson C, Litton E, Nair P, Orford N, Pellegrino V, Shekar K, Trapani T, Pilcher D. Blend to Limit OxygEN in ECMO: A RanDomised ControllEd Registry (BLENDER) Trial: Study Protocol and Statistical Analysis Plan. Crit Care Resusc. 2023 Aug 4;25(3):118-125. doi: 10.1016/j.ccrj.2023.06.001. Erratum in: Crit Care Resusc. 2024 Feb 01;26(1):60. doi: 10.1016/j.ccrj.2024.01.003. PMID: 37876374; PMCID: PMC10581278.   Trina's editorial - Augustin K, Shinar ZM, Dos Reis Miranda D. Correspondence by Augustin et al. regarding the article "Conservative or liberal oxygen targets in patients on venoarterial extracorporeal membrane oxygenation". Intensive Care Med. 2025 Jan 21. doi: 10.1007/s00134-025-07791-7. Epub ahead of print. PMID: 39836262.

    36 min

  3. 12/26/2024

    EDECMO 93: Do you Blend? with Trina Augustin

    This seems like such a basic question and yet the answer is not an answer at all.  Rather it is an educated opinion.  Today we ask the question - Should we blend ECPR patients? Here's the basic problem.  We think hyperoxemia in critically ill patients is bad (Remember hyperoxemia is high oxygen in blood, hyperoxia is high oxygen in the tissue).  We think that hypoxemia in critically ill patients is bad.  So if a patient gets put on ECMO and we can make the oxygen level coming out of the machine whatever level we want, what level should we set it at? Well, today, Trina Augustin teaches how this seemingly simple problem is actually quite complex.  Trina is an ECMO superstar.  She practices at Mayo in Rochester as CV Intensivist with a background in CC/EM.  She teaches the most complex part of Reanimate - post pump critical care and yes she cannulates patients as well.  Listen to Zack and Trina banter over this complex topic specifically focusing on the release of the Blender Trial. EMCRIT ECMO Podcast with Trina that is awesome! - CV-EMCrit - MCS Minute Series: Differential Gas Exchange on Peripheral Femoral VA ECMO with Trina Bibliography: Winiszewski H, Guinot PG, Schmidt M, Besch G, Piton G, Perrotti A, Lorusso R, Kimmoun A, Capellier G. Optimizing PO2 during peripheral veno-arterial ECMO: a narrative review. Crit Care. 2022 Jul 26;26(1):226. doi: 10.1186/s13054-022-04102-0. PMID: 35883117; PMCID: PMC9316319. Bureau C, Schmidt M, Chommeloux J, Rivals I, Similowski T, Hékimian G, Luyt CE, Niérat MC, Dangers L, Dres M, Combes A, Morélot-Panzini C, Demoule A. Increasing Sweep Gas Flow Reduces Respiratory Drive and Dyspnea in Nonintubated Venoarterial Extracorporeal Membrane Oxygenation Patients: A Pilot Study. Anesthesiology. 2024 Jul 1;141(1):87-99. doi: 10.1097/ALN.0000000000004962. PMID: 38436930. Burrell A, Ng S, Ottosen K, Bailey M, Buscher H, Fraser J, Udy A, Gattas D, Totaro R, Bellomo R, Forrest P, Martin E, Reid L, Ziegenfuss M, Eastwood G, Higgins A, Hodgson C, Litton E, Nair P, Orford N, Pellegrino V, Shekar K, Trapani T, Pilcher D. Blend to Limit OxygEN in ECMO: A RanDomised ControllEd Registry (BLENDER) Trial: Study Protocol and Statistical Analysis Plan. Crit Care Resusc. 2023 Aug 4;25(3):118-125. doi: 10.1016/j.ccrj.2023.06.001. Erratum in: Crit Care Resusc. 2024 Feb 01;26(1):60. doi: 10.1016/j.ccrj.2024.01.003. PMID: 37876374; PMCID: PMC10581278.

    51 min

  4. 11/07/2024

    92 – Mark Dennis – Pearls from Sydney

    EDECMO episode 92 features Dr. Mark Dennis, a cardiologist from Sydney, who has published extensively in the field of ECPR.  Zack and Mark talk about so many subjects including pre-hospital considerations, algorithmic management of post ECMO initiation cardiac arrest patients, ventilation management of ECPR patients and much more. Prof Dennis would like to thank all the ambulance paramedics, ED docs, intensive care specialists, surgeons, radiologists, nurses and cardiologists across Sydney. Without their support none of the work would be possible. Also very special thanks to Natalie Kruit and Brian Burns for their immense efforts to bring ECPR to Sydney. Blender Trial - Conservative or liberal oxygen targets in patients on venoarterial extracorporeal membrane oxygenation | Intensive Care Medicine CO2 Drop in VA ECMO - ELSO Registry - Critical Care Medicine

    57 min

  5. 09/08/2024

    91 – Stay and Play to Shock, Shock, Go!!

    Should we keep cardiac arrest patients on the scene when we have the ability to put them on ECMO in the hospital?  That is the question we tackle this month on EDECMO.  Brian Grunau and the great crew from Prague published a study looking at the Hyperinvasive trial data.  They make some profound observations about the benefits of ECPR and some data supporting transporting patients early in functional ECPR systems. Saul Levine and Jonathan Goldstone from the SDRC join the podcast this month to give their insight into the formation of ECPR receiving centers as well as the paper.   Grunau's Paper   * The time-dependent yield of invasive vs. standard resuscitation strategies: A secondary analysis of the Prague out-of-hospital cardiac arrest study Grunau, Brian et al. Resuscitation, Volume 0, Issue 0, 110347 Editorial Shock, Shock, Go

    22 min

  6. 05/02/2024

    90 – ECMO in Trauma with Dr. Powell & Dr. O’Connor

    In this episode of the ED ECMO Podcast, hosts Zack Shinar and Jon Marinaro interview Dr. Powell & Dr. O'Connor from Baltimore Shock Trauma, exploring ECMO's critical role in trauma care and its impact on patient outcomes. They discuss patient selection criteria for ECMO, managing hemorrhage and anticoagulation considerations, choosing between veno-arterial and veno-venous ECMO, practical insights on vascular access, and strategies for team coordination during ECMO emergencies. This discussion is essential for trauma surgeons, emergency physicians, critical care teams, perfusionists, and anyone involved in trauma care or ECMO deployment.

    59 min

  7. 04/04/2024

    89 – What a Medical Student Should Know: Part 1

    With the growing prevalence of ECPR, it is now more important than ever for all individuals in the medical community to understand what ECMO is, not just those providers who are directly involved with its use. In this new podcast series, Zack Shinar and Jon Marinaro help Nathaniel Dennis-Benford, a first-year medical student, explore what a medical student should know about ECMO and ECPR. In this first episode of the series, we start from the basics: what is "cardiac arrest", how is it traditionally managed, and finally what even is ECMO?   AHA recommendations for ECPR at 2A - see article here Free link for Zack and Dinis editorial on Lactate use here

    40 min

  8. 01/13/2024

    88 – ECMO Billing with John Mehall

    If you are running or starting a US ECMO program, this episode is a must listen.  John Mehall from Innovative ECMO Concepts goes through the financial aspects of ECMO care.  He covers everything from hospital charges to physician reimbursement to areas where hospitals commonly fail.  We all know that you cannot have a successful ECMO program unless you have sufficient funding to keep it going.  Jon Marinaro, Zack Shinar, and an entire audience of Reanimate 9 attendees join the episode to ask questions and give their own insight. Web Pricer (cms.gov) - your hospital weight.  Times it by DRG to get your hospital ECMO compensation.

    54 min
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4.6
out of 5
86 Ratings

About

The ED ECMO Project is the work of Zack Shinar and Jon Marinaro to bring extracorporeal life support to EDs and ICUs around the world. This site aims to be the ultimate resource for the background, logistics, and evidence for resuscitative ECMO.

Information

  • Creator
    Zack Shinar, MD
  • Years Active
    2013 - 2025
  • Episodes
    162
  • Rating
    Clean
  • Copyright
    © EDECMO 2013-
  • Show Website
    EDECMO Podcast

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