Functional evaluation of sublingual microcirculation indicates successful weaning from VA-ECMO in cardiogenic shock

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly adopted for the treatment of cardiogenic shock (CS). However, a marker of successful weaning remains largely unknown. Our hypothesis was that successful weaning is associated with sustained microcirculatory function during ECMO flow reduction. Therefore, we sought to test the usefulness of microcirculatory imaging in the same sublingual spot, using incident dark field (IDF) imaging in assessing successful weaning from VA-ECMO and compare IDF imaging with echocardiographic parameters. Methods: Weaning was performed by decreasing the VA-ECMO flow to 50% (F50) from the baseline

Surgery for a large tracheoesophageal fistula using extracorporeal membrane oxygenation

We report a patient with a giant tracheoesophageal fistula (TEF) planned for reconstructive surgery. Because mechanical ventilation in any form was technically impossible, we successfully used venovenous extracorporeal membrane oxygenation (VV-ECMO) without the need for mechanical ventilation