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
#ECMO center volume: any association with #ECLS related complications? Analysis of @theelso.bsky.social Registry.
Higher volume may lead to ⬆️ experience translating to ⬆️ vigilance = early detection of ECMO complications, but also to initiation within larger, more complex population.
🖇️ bit.ly/3MP3mr1
#ECMO center volume & complications in adults
🔎 ELSO Registry, 2018-2021
🫁 >9.4K VV, average volume 74
🫀 >10.7K VA, average volume 80
🚑 >3.5 #ECPR, average volume 89
Higher volumes associated with ⬇️ hemorrhagic complications for VA/VV, ⬆️ mechanical complications for VA (not ECPR).
🖇️ bit.ly/3MP3mr1
February 18, 2026 at 9:26 AM
Reposted by M Velia Antonini
📘 Blue Book: #ECMO Specialist Training Manual chapter 13, #ECLS circuit & component changes
⚙️ pt management
⚙️ change-out supplies/procedure
⚙️ circuit & selective components replacement: ML, pump-head/raceway, tubing, connector, stopcock/pigtail, AV bridge
⚙️ post-replacement phase
🛒 bit.ly/ELSObooks
February 17, 2026 at 5:05 PM
Exploratory laparotomy in #ECMO
🩺 indications? bowel pneumatosis, portal venous gas, free air, mesenteric edema, distention + rapid Hb decrease, increasing vasopressors or ventilatory pressure
🩸 most ischemic injuries? watershed hypoperfusion due to CS or ECMO: thromboembolism rare
🔗 bit.ly/4alLSvB
Exploratory laparotomy in patients on #ECMO
🔍 >1,3K #ECLS patients: 4% abdominal exploration
🔪 procedures pts resection of necrotic bowel, repair of perforations, other
🪦 mortality 57%; higher disease severity scores/mesenteric ischemia: significant factors influencing mortality
🔗 bit.ly/4alLSvB
February 16, 2026 at 4:37 PM
Homemade #ECMO cannulation model for simulation training
♻️ customizable low cost phantom: agar-agar, household materials, repurposed medical components
🖥️ enables #POCUS guided access, cannula insertion, EBF initiation; can be easily integrated in mannequins
@asaiojournal.bsky.social
🔓 bit.ly/4al18ZC
February 15, 2026 at 6:09 PM
RBC transfusion decision making in non bleeding critically ill
🩸 DO2/VO2 + adaptation mechanisms to Hb drop
🩸 should RBC transfusion be not only Hb based?
🩺 evidence supporting use of physiological triggers: ScvO2, A-V O2 difference, O2ER, lactate, troponin, tissue perfusion, PbtO2
🔓 rdcu.be/e31QP
February 14, 2026 at 7:37 PM
Reposted by M Velia Antonini
🎥 Recordings of joint EuroELSO & SEMICYUC webinar: #ECMO in Out-of-Hospital Cardiac Arrest: a matter of time and details in NOW available open access
🔓 www.youtube.com/watch?v=egV63igN41g
🚁 Organization & patient selection: Dutch HEMS experience
🩺 Practical aspects of cannulation/initial management
February 14, 2026 at 6:08 PM
Driving vs transpulmonary pressure?
🫁 ΔP = Pplat - total PEEP
🫁 PL = Paw - Ppl (Ppl approximated by Pes)
🗝️ key advantage of PL? allows to distinguish lung vs chest wall mechanics
ΔP enables individualization of VT according to size of baby lung; PL allows to titrate PEEP
#FOAMcc
🔓 rdcu.be/e3TSf
February 13, 2026 at 6:18 PM
Reposted by M Velia Antonini
Just over a week to go until our next BTPT webinar! Make sure you sign up now to secure your space - tinyurl.com/liverkidneyt...
Join us for an expert-led session on Liver–Kidney Transplantation with Dr Sapna Shah — Clinical Lead for Kidney Transplantation at King’s College Hospital!

📅 18 Feb | ⏰ 7:30pm GMT
💻 Online
🔗 tinyurl.com/liverkidneyt...

#TransplantMedicine #LiverKidney #BTPT #Nephrology #Hepatology
February 12, 2026 at 8:04 PM
Reposted by M Velia Antonini
🎥 Celebration of Dr Bartlett is live youtube.com/@TheELSO
1️⃣ Welcome
2️⃣ Renaissance man
3️⃣ The Clinician
4️⃣ Clinical researcher & inventor
5️⃣ ECMO origins
6️⃣ Maturation of ECMO
7️⃣ ELSO - Bob's vision for a global #ECMO community
8️⃣ The patients' view
9️⃣ Lessons from Bob
1️⃣0️⃣ Closing remarks
1️⃣1️⃣ Music program
February 12, 2026 at 8:57 PM
🩸 Noninvasive approach for real-time detection of thrombi in #ECMO circuits using acoustic measurements, not requiring any modifications. This technique may be used to develop a system to warn of potential clots, to be coupled with clinical observations.
@asaiojournal.bsky.social
🔓 bit.ly/4at1snM
How to detect thrombi in #ECMO circuits??
))))) noninvasive approach using acoustic measurements
🩸 compared with visual observations total accuracy 84%; hypothesizing that some false positives were indicators of clots, the accuracy may be up to 96%
@asaiojournal.bsky.social
🔓 bit.ly/4at1snM
February 11, 2026 at 7:18 PM
Prone positioning in VV #ECMO?? no net physiological benefit after #ECLS initiation in this animal model 🐖 with severe #ARDS randomized after VV initiation to prone or supine positioning for 48 h, receiving an ultraprotective MV strategy 🫁
Open access #FOAMcc #FOAMecmo
🔓 rdcu.be/e28tP
Prone positioning in VV #ECMO
🐖 8 pigs with severe #ARDS randomized after VV initiation
🫁 PP did not reduce the overall extent/severity of lung injury but shifted distribution of damage, with greater involvement of dependent regions and relative preservation of non-dependent areas.
🔓 rdcu.be/e28tP
February 9, 2026 at 5:33 PM
Reposted by M Velia Antonini
(Circuit) integration or separation approach in #ECMO patients requiring #CRRT? E-CRRT RCT
🔎 80 pts allocated to circuits integration vs separation
⚖️ no significant difference in filter lifespan
🪦 comparable mortality
🫧 no differences in serious adverse events including air embolism
🔓 rdcu.be/e2FyX
February 6, 2026 at 3:38 PM
Reposted by M Velia Antonini
📖 Monitoring #extracorporeal circuit and pt on #ECLS: Blue Book, chapter 12
🖥️ circuit: pressures, EBF meters, air/bubble detectors, OxyHb monitoring, temperature
🖥️ patient: arterial BP, SpO2, Sc/SVO2, rSO2, EtCO2, PAC, #POCUS, neuromonitoring
📘 the #ECMO Specialist Training Manual
🛒 bit.ly/ELSObooks
February 4, 2026 at 3:45 PM
VA #ECMO related axillary artery cannulation & aortic hemodynamics
☢️ insights from computational fluid dynamics models derived from 10 CT-based geometries to simulate flow via right or left axillary artery access under varying levels of cardiac dysfunction
@asaiojournal.bsky.social
🖇️ bit.ly/3OkAPKd
VA #ECMO & axillary a. cannulation: insights from computational fluid dynamics
🫀 RAA more frequently resulted in retrograde flow, particularly in type III arch
🫀 LAA promoted antegrade or arch-split flow: may provide more favourable antegrade flow, particularly if CO impaired
🖇️ bit.ly/3OkAPKd
February 3, 2026 at 8:28 PM
📢 #ECMO in OHCA: a matter of time and details, joint webinar EuroELSO & @semicyuc.bsky.social
🚁 Organization and patient selection: Dutch HEMS experience
🩺 Cannulation and initial management
🎤 Q/A
📆 Feb 10 2026, 15:30 CET
Register 🖋 www.euroelso.net/webinars/

Lectures in 🇬🇧
Q/A translated in 🇪🇸
February 3, 2026 at 2:02 PM
Invasive ABP? True monitoring tool
🎯 accurate interpretation
🫀 physiological insights: aortic pressure, arterial compliance, reflection waves, peripheral BP
🩺 applications & targets: MAP/organ perfusion, PP/DV, DBP/vascular tone, SBP/LV afterload
🌊 PPV & fluid responsiveness
#FOAMcc
🔓 bit.ly/3LJYsva
February 2, 2026 at 10:37 AM
Reposted by M Velia Antonini
🍽️ 2025 ELSO Consensus statement for provision & management of nutrition therapy in critically ill adult patients requiring #ECMO
@asaiojournal.bsky.social
🔓 bit.ly/45BLRkq
January 30, 2026 at 6:55 PM
📖 Priming the #ECMO circuit
💧 pre-priming: rationale
📦 considerations, storage, management
💧crystalloid prime procedure
💧fluid selection: NS vs balanced crystalloid solutions
🩸blood prime: steps & considerations
The chapter includes online files for download (checklists + editable labels)... Enjoy
📖 Priming the #ECLS: let's open the Blue Book! Chapter 11 is focused on this practice, essential to initiate #ECMO support:
📦 pre-priming
💧crystalloid prime
🩸blood prime
The chapter includes online supplementary files available for download
📘 the #ECMO Specialist is available!
🛒 bit.ly/ELSObooks
January 29, 2026 at 6:24 PM
Reposted by M Velia Antonini
The ELSO Registry Data Quality and Integrity Program. The Registry is used by various stakeholders to
🥅 improve patient & institutional care quality
📊 support research
📦 support device regulation,
🖥️ monitor practice patterns
📰 share best practices.
@asaiojournal.bsky.social
🔓 bit.ly/4k9e9IX
January 28, 2026 at 4:58 PM
Ultrasound in #ECMO? #POCUS ubiquitous & indispensable in the care of #ECLS patients, from indication to choice of configuration, cannulation, monitoring, weaning and post decannulation.
@asaiojournal.bsky.social #FOAMcc #FOAMecmo #FOAMus #echofirst
🔓 bit.ly/4bUMDN6
Ultrasound in #ECMO state-of-the-art review
📚 training for #ultrasound in #ECLS
🖥️ choice of mode
🫀🫁 US pre Initiation in CS & respiratory failure
🍼 neonatal & pediatric considerations #PedsICU
🖥️ role for cannulation
🖥️ monitoring & troubleshooting
🖥️ vascular US
🧠 neuro US
🖥️ weaning
🔓 bit.ly/4bUMDN6
January 27, 2026 at 5:06 PM
Reposted by M Velia Antonini
The January #ISHLTJournalWatch focuses on topics in #transplant #pharmacy, edited by Colleen Hutchinson. 💊

Topics include the NUDT16 genotype, #daratumumab monotherapy, & early mammalian target of rapamycin inhibitor (#mTORi).

🔗 www.ishlt.org/about/news-d...

#TransplantSky #PharmSky
Pharmacy in Heart and Lung Transplant: The Latest Studies in ISHLT Journal Watch
The first Journal Watch of 2026 explores topics in transplant pharmacy, including valganciclovir for CMV, daratumumab monotherapy, and renal sparing in heart transplant recipients.
www.ishlt.org
January 26, 2026 at 3:23 PM
Ultrafiltration in critically ill
🩺 physiological effects & response to UF
🖥️ monitoring & guidance
💦 UF intolerance
🫀 intolerance endotypes: preload dependence, cardiac dysfunction, ⬇️ vascular tone, autonomic dysfunction, ⬇️ vascular refill
🪡🧵 rationale & step towards personalized UF
🔓 rdcu.be/e0XBg
January 27, 2026 at 2:28 PM
Reposted by M Velia Antonini
🎤 The celebration of the life and legacy of Dr. Robert H. Bartlett is ongoing at Hill Auditorium in Ann Arbor, MI. We are honouring the Father of #ECMO with a day of talks and tributes given by Bob's colleagues, peers, friends, family. We are uploading a photo book on our Fb page
📸 bit.ly/3NDUDrU
January 26, 2026 at 6:27 PM
Pharmacologic & toxicologic confounders in brain death determination
🧠 coma
🧠 BD & death by neurologic criteria
💉 controversies in existing BD declaration guidelines
🚧 PK & PD challenges: hypothermia, organ failure, obesity, prolonged infusions, toxicokinetics
🛟 ancillary testing
🔓 rdcu.be/e0C9u
January 25, 2026 at 1:00 PM
Conversion from VV to VA or hybrid #ECMO configuration in patients treated for refractory respiratory failure developing refractory hypoxemia or hemodynamic compromise? Higher mortality/complications rate. Initial configuration selection pivotal!
@critcaremed.bsky.social
🔗 bit.ly/4pT9Na1
Conversion from VV to VA or hybrid #ECMO, analysis of ELSO Registry including 29K adults
🫀 2.4% received a change from original configuration, 56.8% to VA, 43.2% to hybrid #ECLS
⚖️ increased clinical & circuit complications reported in converted patients; in-hospital mortality higher
🔗 bit.ly/4pT9Na1
January 24, 2026 at 6:41 PM