M Velia Antonini
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foamecmo.bsky.social
M Velia Antonini
@foamecmo.bsky.social
Perfusionist, E-AEC, ECMO & NRP specialist + POCUS
EuroELSO Steering C & Chair NRP Working Group
ELSOeducation taskforce
SoMe Director @TheELSO
SoMe Editor @asaiojournal
Pinned
TA #NRP in cDCD heart donors using fully mobile closed #ECMO circuit, modified to provide
🩸🌡️effective NRP to support combined thoraco/abdominal organs recovery
🫀LV venting
🫀 fast conversion to central configuration as needed
⭕️ shunt for recirculation
🫧 air management
#FOAMcc
🔓 bit.ly/TANRPasaio
Critical care management of pharmaceutical poisoning
⏱️ initial assessment + #resuscitation
🔍 diagnostic approach
☠️ poisoning specific strategies
⚖️ toxicant-specific strategies + antidotes
🚨 rescue strategies including #ECMO (#ECPR, VA, VV for aspiration or inhalational injuries)
🔓 rdcu.be/ePGFM
November 13, 2025 at 10:22 AM
Mastering vasopressin in septic shock, pragmatic bedside guidance on its optimal use, emphasizing real-world constraints & evidence gaps:
💉 clinical pharmacology
⚖️ dosing
⏱️ timing
🩺 practical considerations
#FOAMcc @intenscaremed.bsky.social
🔓 rdcu.be/ePAno
November 12, 2025 at 7:37 PM
#Trauma: contraindication for extracorporeal support in patients evolving to cardiac arrest?? NO! #ECPR can be used to restore circulation in trauma patients with CA! @theelso.bsky.social Registry analysis 2020-2024: survival? Higher than expected! @resuscitation.bsky.social
#FOAMcc
🔓 bit.ly/3LtxJCz
#ECPR in trauma patients with CA
🔍 ELSO Registry analysis
🚑 17.9% received #ECMO because of traumatic CA, ⅓ #OHCA. Survival 29.2%
🚑 82.1% because of CA of medical etiology; survival 37.3%
ECPR may result in higher-than-expected survival, evenmin patients with traumatic CA.
#FOAMcc
🔓 bit.ly/3LtxJCz
November 12, 2025 at 5:31 PM
How not to panic on #ECMO?? Take a look at the ⚠️ Panic Button section of @theelso.bsky.social Bedside Guide!
You can use this free app to learn/train your team on how to manage emergencies during the run!
Apple 📱 bit.ly/ELSOBedsideG...
Google Play 📱 bit.ly/ELSOBedsideG...
Take a look at the ⚠️ Panic Button section of the ELSO's #ECMO Bedside Guide
🩸 accidental decannulation
🫧🫧 air in the circuit
🩸blood out of the circuit
🫀cardiac arrest
⛔️ NO flow
🚨 coming off #ECLS emergently
The app is free open access
Apple 📱 bit.ly/ELSOBedsideG...
Android 📱 bit.ly/ELSOBedsideG...
November 11, 2025 at 8:20 PM
VV multisite #ECMO in neonates & small children?
Increasingly used to avoid neurologic risk of VA #ECLS & technical difficulties of DLCs!
⚖️ percutaneous cannulas smaller vs surgical but
🩸 adequate flows delivered w 10 Fr access/8 return in neonates + 12 access/10 return in older pts
🔓 bit.ly/4nNZxz0
VV multisite #ECMO in neonates & smaller children <15 kg with severe resp failure
🔪 surgical VV cannulation associated with greater risk of thrombosis at vessel sites vs percutaneous technique; no significant at 1y. Potential confounder: surgical group younger + smaller weight
🔓 bit.ly/4nNZxz0
November 10, 2025 at 6:13 PM
Returning of #ECMO circuit residual volume at weaning
⚖️ pro/con & 🩸 different strategies
for high resolution supplementary images
🖇️ bit.ly/3LtrL4t
Saving blood: at all times, at all costs? On returning circuit residual volume at #ECMO weaning
⚖️ pro/con of returning vs discarding blood
🩸 considerations related to different strategies: return through pre-pump access, pre-ML, ML, post-ML, A-V bridge, and use of cell saver
🖇️ bit.ly/47JJADF
November 9, 2025 at 6:19 PM
Saving blood: at all times, at all costs? On returning circuit residual volume at #ECMO weaning
⚖️ pro/con of returning vs discarding blood
🩸 considerations related to different strategies: return through pre-pump access, pre-ML, ML, post-ML, A-V bridge, and use of cell saver
🖇️ bit.ly/47JJADF
November 7, 2025 at 8:28 PM
Reposted by M Velia Antonini
#ECMO in liver #transplantation:
🔍 @mayoclinic.org experience, largest 🇺🇸 series to date
🩺 overall survival suboptimal: 33.3%; all pts discharged from hospital were alive at 1 y
🚧 significant complications: #AKI requiring CRRT (40%), neuro-complications (40%), bleeding
🔗 bit.ly/4hLZmm7
#ECMO across perioperative stages of liver #transplantation:
📚 growing use, also intra/preop, but outcomes remain poor (better if intra/postop). Improved survival may depend on careful pt selection, optimal timing of initiation, distinguishing reversible vs irreversible pathology
🔗 bit.ly/4hLZmm7
November 6, 2025 at 5:15 PM
Reposted by M Velia Antonini
📦📦 Wrapping up an amazing week in Ann Arbor with 2️⃣ Adult #ECMO #simulation course: a total of 5️⃣8️⃣ learners strong! Huge thanks to our dedicated faculty & enthusiastic learners for making courses both educational and fun ‼️ Next sessions
🗓️ April 14-15 & 16-17 2026
📍 Ann Arbor MI
🎓 bit.ly/ELSOAcademy
November 7, 2025 at 5:09 PM
#ECMO across perioperative stages of liver #transplantation:
📚 growing use, also intra/preop, but outcomes remain poor (better if intra/postop). Improved survival may depend on careful pt selection, optimal timing of initiation, distinguishing reversible vs irreversible pathology
🔗 bit.ly/4hLZmm7
November 6, 2025 at 5:13 PM
Reposted by M Velia Antonini
Tilt bed for mobilization on #ECMO?? Seems safe & effective strategy to facilitate #ICUrehab! These beds may provide reasonable alternative or additive therapy to out-of-bed mobility, particularly among centers that lack staffing or experience to safely coordinate ambulation.
🔗 bit.ly/4hKcJ6x
November 5, 2025 at 4:49 PM
Reposted by M Velia Antonini
📘 The Blue Book: the latest edition of ELSO ECMO Specialist Training Manual is NOW available
🛒 bit.ly/ELSObooks
📖 Let's open the book and start with Dedication, with immense gratitude and affection, to Robert & Wanda Bartlett. Dr Bartlett wrote Foreword of Blue Book.
November 4, 2025 at 5:11 AM
🎥 Replay of #EuroELSOwebinar: Post-Cardiotomy #ECL is now available open access enjoy! #FOAMcc #FOAMecmo
⚖️ Indications, timing and settings
🫀 Unloading, hybrid configurations & difficult cases
🖥️ Joint #ICU management: monitoring, anticoagulation, ventilation
🩺 Case
🎥 youtube.com/watch?v=AlHJ1f026AM
November 3, 2025 at 5:15 PM
Reposted by M Velia Antonini
🎥 How to operationalize practice standards complicated by #ECMO at virtual #ELSO2025
🫘 integrating #RRT into circuit
💪🏼 designing/implementing early mobility protocol for #ECLS #ICUrehab
🫁 oxygenation riddles
Register
🔗 bit.ly/ELSO2025virt...
If you joined in Washington
🔗 elso2025.teneventsmedia.com
November 3, 2025 at 2:39 PM
📢 call for EuroELSO grant proposals 2026!
2️⃣ grants (MAX value 30K € 💶) available aimed at both adult & pediatric research equally, from healthcare professionists or research scientists
🗓️ Deadline: Dec 15, 2025
🔗 bit.ly/EuroELSOgrants
🏆 awarded candidates will present at #EuroELSO2026 in Dublin 🇮🇪
November 2, 2025 at 8:49 AM
#ECMO for severe CCB toxicity? #ECLS provides potentially lifesaving intervention for pts unresponsive to medical therapy. Outcomes most favourable without pre ECMO CA & with preserved pH. Early identification, rapid cannulation, avoidance of #ECPR may be critical for success.
🔗 bit.ly/48PYtGW
#ECMO for severe calcium channel blocker intoxication in patient with cardiogenic shock/circulatory collapse:
🔍 analysis of the Extracorporeal Life Support Organization Registry, 2015 -2023
🔎 157 patients with CCB toxicity, overall survival higher in pediatric patients vs adults
🔗 bit.ly/48PYtGW
October 31, 2025 at 5:13 PM
Reposted by M Velia Antonini
Take a look at the 💉 Medication section of the ELSO's #ECMO Bedside Guide:
🩸anticoagulants
🩸 blood products
🩸 hemostatic agents
🌸 opioids
🛌 sedatives
Open access app, to be useful to everyone with interest in #ECLS.
Apple store 📱 bit.ly/ELSOBedsideG...
Google Play (Android) 📱 bit.ly/ELSOBedsideG...
October 30, 2025 at 6:58 PM
Another successful @esicm.bsky.social & EuroELSO #ECMO workshop at #LIVES2025 in Munich 🇩🇪 !!
We had 5 sessions over 3 days
🫀VA 🫁 VV #ECLS + ECPR #simulation
🚧 circuit & complications troubleshooting
🚑 ECPR cannulation/initiation
See you at #EuroELSO2026 in Dublin 🇮🇪 & #LIVES2026 in Lisbon 🇵🇹!
October 29, 2025 at 5:07 PM
Reposted by M Velia Antonini
Dear ELSO Community, thank you for all the fond memories and support regarding Dr. Bartlett. His wishes are to gather friends in a few months' time on his behalf. The planning for this memorial is under way and we expect to have a date identified soon. More information to come soon.
October 28, 2025 at 3:26 PM
Adult & pediatric special circumstances of #resuscitation: 2025 @americanheart.bsky.social guidelines are are out! While #ECMO is not available in every setting, may be considered for adults & children in CA or peri-arrest state with potentially reversible etiology
🔓 bit.ly/3LeVAWd
See thread 🧵🪡 1/2
October 27, 2025 at 5:27 PM
The ELSO guideline on #ECMO for accidental hypothermia:
🧊 do NOT use criteria established for normothermic pts!
Hypothermic CA? better survival/neuro-outcome. Unwitnessed CA, asystole, long no/low-flow times, age ≥70, low EtCO2 NOT contraindications to #ECPR in hypothermia.
🔓 bit.ly/475GUkR
The ELSO 2025 narrative guideline on use of #ECMO for accidental hypothermia
🔗 preparation and organization
🧊 patient selection & indications for ECLS
⚖️# ECMO mode/technical considerations
🩺 patient + circuit management during ECLS
🚧 complications
🪽 weaning
🔍 outcome & follow up
🔓 bit.ly/475GUkR
October 23, 2025 at 4:34 PM
The ERC 2025 cardio-pulmonary resuscitation guidelines are out!
🫀 adult basic & advanced life support
🧸 pediatric life support
🍼 neonatal life support
🚧 special circumstances
🩺 post-resus care
⚖️ ethics
📋 system saving lives
🎓 education for #resuscitation
🔍 epidemiology
🩹 first aid
🔓 bit.ly/4qkPTWO
October 22, 2025 at 2:16 PM
Reposted by M Velia Antonini
Key point from my invasive CO talk the other day #CHEST2025
October 21, 2025 at 1:25 PM
Myth-busting on periop autologous red blood cell salvage
🚿overview of process
Myths on cell-salvaged blood
⚖️ 1️⃣ poor quality/inferior to allogeneic RBCs
🩸 2️⃣ increases bleeding
🚧 3️⃣ not safe in many surgeries
💶 4️⃣ not cost-effective
#FOAMcc @anesthesiology.bsky.social @asahq.bsky.social
🔓 bit.ly/47vZfrk
October 19, 2025 at 10:36 AM
Reposted by M Velia Antonini
I would normally not have batted an eye at this paper

But it’s by Robert Hahn, and is a nice overview of everything we know about fluid redistribution in the critically unwell- including gel phase, some glycocalyx stuff, 3 compartment models, and albumin escape rates

#foamed
Where does the fluid go?
💦 morphological changes/damage by fluid overload
🛌 fluid distribution in anesthesia
3️⃣ extracellular fluid compartments
💧 physiology, manipulation & max filling of slow-exchange fluid space
🔥 inflammation, capillary leakage & lymphatic flow 💦
🥚 albumin
🔓 rdcu.be/eLnfi
October 18, 2025 at 5:12 PM