{"id":3781,"date":"2018-02-20T13:06:35","date_gmt":"2018-02-20T17:06:35","guid":{"rendered":"https:\/\/edecmo.org\/?p=3781"},"modified":"2018-03-15T17:42:10","modified_gmt":"2018-03-15T21:42:10","slug":"edecmo-43-cutdown","status":"publish","type":"post","link":"https:\/\/edecmo.org\/edecmo-43-cutdown\/","title":{"rendered":"EDECMO 43: The Cutdown"},"content":{"rendered":"<!--powerpress_player--><div class=\"powerpress_player\" id=\"powerpress_player_8716\"><!--[if lt IE 9]><script>document.createElement('audio');<\/script><![endif]-->\n<audio class=\"wp-audio-shortcode\" id=\"audio-3781-1\" preload=\"none\" style=\"width: 100%;\" controls=\"controls\"><source type=\"audio\/mpeg\" src=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/The_Cutdown_Alice.mp3?_=1\" \/><a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/The_Cutdown_Alice.mp3\">http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/The_Cutdown_Alice.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\/The_Cutdown_Alice.mp3\" class=\"powerpress_link_pinw\" target=\"_blank\" title=\"Play in new window\" onclick=\"return powerpress_pinw('https:\/\/edecmo.org\/?powerpress_pinw=3781-podcast');\" rel=\"nofollow\">Play in new window<\/a> | <a href=\"http:\/\/media.blubrry.com\/edecmo\/traffic.libsyn.com\/edecmo\/The_Cutdown_Alice.mp3\" class=\"powerpress_link_d\" title=\"Download\" rel=\"nofollow\" download=\"The_Cutdown_Alice.mp3\">Download<\/a> (Duration: 29:49 &#8212; 24.0MB)<\/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><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-3792 alignleft\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2018\/02\/The-Cutdown270.png\" alt=\"\" width=\"270\" height=\"203\" \/><strong>The Cutdown Approach to ECMO Cannula Insertion with Alice Hutin, Lionel Lamhaut, and\u00a0Zack Shinar<\/strong><\/p>\n<p>In this episode,\u00a0 Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion.\u00a0 She is an emergency physician who is one of four physicians who cannulates on the pre-hosp<img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3785 alignright\" src=\"https:\/\/edecmo.org\/wp-content\/uploads\/2018\/02\/alice-zack-lionel-740x416.jpg\" alt=\"\" width=\"292\" height=\"164\" srcset=\"https:\/\/edecmo.org\/wp-content\/uploads\/2018\/02\/alice-zack-lionel-740x416.jpg 740w, https:\/\/edecmo.org\/wp-content\/uploads\/2018\/02\/alice-zack-lionel-768x432.jpg 768w, https:\/\/edecmo.org\/wp-content\/uploads\/2018\/02\/alice-zack-lionel-1024x576.jpg 1024w, https:\/\/edecmo.org\/wp-content\/uploads\/2018\/02\/alice-zack-lionel.jpg 1200w\" sizes=\"(max-width: 292px) 100vw, 292px\" \/>ital ECMO ambulance.\u00a0 She describes the process of their modified cutdown.\u00a0 We are holding off on written descriptions and pictures of the procedure pending Alice&#8217;s publication so you will just have to listen!!!! We&#8217;ll post the pictures soon!\u00a0 Until then, here is a youtube segment showing a femoral cutdown -https:\/\/www.youtube.com\/watch?v=zzu7cU3YoXo<\/p>\n<p>&nbsp;<\/p>\n<p>Another recent publication by Alice:<\/p>\n<p>Hutin A, Lamhaut L, Lidouren F, Kohlhauer M, Mongardon N, Carli P, Berdeaux A, Ghaleh B, Tissier R.\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28007740\">Early Coronary Reperfusion Facilitates Return of Spontaneous Circulation and Improves Cardiovascular Outcomes After Ischemic Cardiac Arrest and Extracorporeal Resuscitation in Pigs.<\/a>\u00a0J Am Heart Assoc. 2016 Dec 22;5(12). pii: e004588. doi: <span id=\"Q3kiRFpuCjFIQRNoOaYWx\" class=\"abt-citation noselect mceNonEditable\" data-reflist=\"[&quot;3775448764&quot;]\" data-footnote=\"undefined\"><sup>1<\/sup><\/span>. PubMed PMID: 28007740; PubMed Central PMCID: PMC5210433<\/p>\n<div id=\"abt-bibliography\" class=\"abt-bibliography noselect mceNonEditable\" data-reflist=\"[&quot;3775448764&quot;]\"><button class=\"abt-bibliography__heading abt-bibliography__heading_toggle\" aria-expanded=\"false\" aria-controls=\"abt-bibliography__container\" data-heading-level=\"h3\">References<\/button><\/p>\n<div id=\"abt-bibliography__container\" class=\"abt-bibliography__container\">\n<div id=\"3775448764\">\n<div class=\"csl-entry flush\">\n<div class=\"csl-left-margin\">1.<\/div>\n<div class=\"csl-right-inline\">Hutin A, Lamhaut L, Lidouren F, et al. Early Coronary Reperfusion Facilitates Return of Spontaneous Circulation and Improves Cardiovascular Outcomes After Ischemic Cardiac Arrest and Extracorporeal Resuscitation in Pigs. <i>J<\/i>. 2016;5(12):e004588. doi:<a href=\"https:\/\/doi.org\/10.1161\/jaha.116.004588\" target=\"_blank\" rel=\"noopener noreferrer\">10.1161\/jaha.116.004588<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>In this episode,\u00a0 Alice Hutin of the Paris SAMU talks about the modified cutdown approach to cannula insertion.\u00a0 She is an emergency physician who is one of four physicians who take call on the pre-hospital ECMO ambulance.\u00a0 She describes the process of their modified cutdown.\u00a0 First, incision through the skin is made 2 cm below inguinal crease.\u00a0 Second, blunt dissection down through the soft tissue.\u00a0 This is best done with your fingers.\u00a0 Third, place a needle through the distal skin and visualize it pass into the vessel.\u00a0 From there, you cannulate as with percutaneous.\u00a0 Alice\u2019s recent paper shows a 6% failure rate with this technique in skilled hands.<\/p>\n","protected":false},"author":5,"featured_media":3883,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_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":[286,287,120,72,56,111,172,288,290,289,223],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/edecmo.org\/wp-content\/uploads\/2018\/03\/Canva-Cutdown.jpg","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p3JzC4-YZ","_links":{"self":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/3781"}],"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\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/comments?post=3781"}],"version-history":[{"count":0,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/posts\/3781\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media\/3883"}],"wp:attachment":[{"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/media?parent=3781"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/categories?post=3781"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edecmo.org\/wp-json\/wp\/v2\/tags?post=3781"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}