{"id":2245,"date":"2015-09-10T00:01:52","date_gmt":"2015-09-10T04:01:52","guid":{"rendered":"https:\/\/edecmo.org\/?p=2245"},"modified":"2016-09-24T10:50:12","modified_gmt":"2016-09-24T14:50:12","slug":"edecmo-24-weaning-va-ecmo-with-deirdre-murphy","status":"publish","type":"post","link":"https:\/\/edecmo.org\/edecmo-24-weaning-va-ecmo-with-deirdre-murphy\/","title":{"rendered":"EDECMO 24 &#8211; Weaning VA-ECMO, with Deirdre Murphy"},"content":{"rendered":"<!--powerpress_player--><div class=\"powerpress_player\" id=\"powerpress_player_4693\"><!--[if lt IE 9]><script>document.createElement('audio');<\/script><![endif]-->\n<audio class=\"wp-audio-shortcode\" id=\"audio-2245-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150909-024-ecmo-weaning.mp3?_=1\" \/><a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150909-024-ecmo-weaning.mp3\">http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150909-024-ecmo-weaning.mp3<\/a><\/audio><\/div><p class=\"powerpress_links powerpress_links_mp3\" style=\"margin-bottom: 1px !important;\">Podcast: <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150909-024-ecmo-weaning.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/edecmo.org\/?powerpress_pinw=2245-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/edecmo-20150909-024-ecmo-weaning.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"edecmo-20150909-024-ecmo-weaning.mp3\">Download<\/a> (Duration: 35:08 &#8212; 12.2MB)<\/p><p class=\"powerpress_links powerpress_subscribe_links\">Subscribe: <a href=\"https:\/\/edecmo.org\/feed\/podcast\/\" class=\"powerpress_link_subscribe powerpress_link_subscribe_rss\" target=\"_blank\" title=\"Subscribe via RSS\" rel=\"nofollow\">RSS<\/a><\/p><p>In this episode, Zack and Joe talk with Deirdre Murphy, the Deputy Director of the ICU, director\u00a0of the cardiothoracic ICU at the Alfred Hospital in Melbourne, Australia. The Alfred has put itself on the map in so many ways over the past decade. Home to Stephen Bernard (of the original Hypothermia after ROSC without RONF fame), Chris Nickson (@precordialthump, @ragepodcast, @intensiveblog, #SMACC,\u00a0lifeinthefastlane.com), and good friends Jason McClure, Steve McGloughlin, Josh Ihle, Paul Nixon, and Deirdre Murphy, The Alfred is becoming a mecca for advanced resuscitation and ECMO\/ECPR. \u00a0In this episode we sat down with Dr. Murphy to discuss the nuances of weaning a patient from ECMO.<\/p>\n<p>As ED Docs, Zack and I find ourselves at the heroic end of the resuscitation spectrum when the dying patient goes on pump&#8230;but what happens at the other end? What happens in the hours, days, and weeks that follow? \u00a0Listen to this episode to find out&#8230;<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_2260\" aria-describedby=\"caption-attachment-2260\" style=\"width: 150px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2260 size-thumbnail\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3-150x150.jpg\" alt=\"Deirdre Murphy MB (Hons), MRCPI, FCARCSI, FCICM, DDU (Crit Care), PGDipEcho\" width=\"150\" height=\"150\" srcset=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3-150x150.jpg 150w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3-32x32.jpg 32w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3-64x64.jpg 64w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3-96x96.jpg 96w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3-128x128.jpg 128w, https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Deidre-Murphy3.jpg 360w\" sizes=\"(max-width: 150px) 100vw, 150px\" \/><\/a><figcaption id=\"caption-attachment-2260\" class=\"wp-caption-text\">Deirdre Murphy MB (Hons), MRCPI, FCARCSI, FCICM, DDU (Crit Care), PGDipEcho<\/figcaption><\/figure>\n<p><strong>Deirdre Murphy\u00a0MB (Hons), MRCPI, FCARCSI, FCICM, DDU (Crit Care), PGDipEcho<\/strong><\/p>\n<p style=\"text-align: justify;\">Deirdre is Deputy Director ICU, Director\u00a0of the Cardiothoracic ICU at The Alfred Hospital with particular interests in echocardiography and cardiac intensive care, especially\u00a0mechanical circulatory supports including Ventricular Assist Devices and ECMO.\u00a0Deirdre originally trained in Ireland with postgraduate training in general medicine\u00a0and anaesthesia prior to undertaking intensive care training in Australia in 1999. She\u00a0has been an Intensivist at The Alfred since 2003. Deirdre has been using echo in\u00a0clinical practice since 2002 and heads the ICU echocardiography programme at the\u00a0Alfred. She is convenor of the Alfred Critical Care Echocardiography Course and the\u00a0Alfred TOE course and teaches on many of the other Alfred courses including the\u00a0Ultrasound, ECMO and HeART courses.<\/p>\n<p style=\"text-align: justify;\">A paper just published in Intensive Care Medicine followed this algorithm:<\/p>\n<p style=\"text-align: justify;\">(Intensive Care Med (2015) 41:902-905)<\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/art-3A10.1007-2Fs00134-015-3663-y.pdf\">How to wean a patient from veno-arterial extracorporeal membrane oxygenation<\/a><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-2246 alignnone\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/Screen-Shot-2015-09-07-at-12.26.16-PM.png\" alt=\"Screen Shot 2015-09-07 at 12.26.16 PM\" width=\"669\" height=\"497\" \/><\/p>\n<h3 style=\"text-align: justify;\">Some Notes<\/h3>\n<h4>Signs of improvement<\/h4>\n<ul>\n<li>Pulsatility indicates the patient is getting better<\/li>\n<li>ETCO2 starts to rise<\/li>\n<li>Weaning Vasopressors<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3 style=\"text-align: justify;\">Want More??<\/h3>\n<p>Check out Dr. Murphy&#8217;s talk from smaccGOLD on <a href=\"http:\/\/intensiveblog.com\/ecmo-go-wrong\/\" target=\"_blank\">&#8220;ECMO: What could go wrong?&#8221;<\/a><\/p>\n<p>Also, check out the incredible resources on <a href=\"http:\/\/intensiveblog.com\/category\/ecmo\/\" target=\"_blank\">ECMO on the\u00a0INTENSIVE blog (the Alfred ICU Education blog)<\/a><\/p>\n<h3>Update:<\/h3>\n<p>Can we use ETCO2 to assess weaning?<\/p>\n<p><a href=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/SNAG-0002-2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-2775\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/SNAG-0002-2.png\" alt=\"snag-0002-2\" width=\"692\" height=\"438\" \/><\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In this episode, Zack and Joe talk with Deirdre Murphy, the Deputy Director of the ICU, director of the cardiothoracic ICU at the Alfred Hospital in Melbourne, Australia. The Alfred has put itself on the map in so many ways over the past decade. Home to Stephen Bernard (of the original Hypothermia after ROSC without RONF fame), Chris Nickson (@precordialthump, @I_C_N, @intensiveblog, #SMACC, lifeinthefastlane.com), and good friends Jason McClue, Steve McGloughlin, Josh Ihle, Paul Nixon, and Deirdre Murphy, The Alfred is becoming a mecca for advanced resuscitation and ECMO\/ECPR.  In this episode we sat down with Dr. Murphy to discuss the nuances of weaning a patient from ECMO.<\/p>\n<p>As ED Docs, Zack and I find ourselves at the heroic end of the resuscitation spectrum when the dying patient goes on pump&#8230;but what happens at the other end? What happens in the hours, days, and weeks that follow?  Listen to this episode to find out&#8230;<\/p>\n","protected":false},"author":4,"featured_media":2276,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":true,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[4],"tags":[156,158,155,120,72,56,157],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/edecmo.org\/wp-content\/uploads\/2015\/09\/45ecmo.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p3JzC4-Ad","_links":{"self":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/2245"}],"collection":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/comments?post=2245"}],"version-history":[{"count":0,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/2245\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media\/2276"}],"wp:attachment":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media?parent=2245"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/categories?post=2245"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/tags?post=2245"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}