SCCM Resource Library-Mechanical 2.0: When You Have More Machines Than People in the Room

Video Transcription

Video Summary

In this video, Dr. Raghavan Murugan, Dr. Dan Nguyen, and Dr. Raj Basu discuss the management of complex patients with multiple machines in the room, specifically focusing on the interaction between mechanical ventilation, dialysis, and ECMO (extracorporeal membrane oxygenation) in the treatment of COVID-19 patients. They highlight the high prevalence of acute kidney injury (AKI) in COVID-19 patients and the need for renal replacement therapy (RRT), such as dialysis or CRRT (continuous renal replacement therapy), in these cases. They discuss the potential mechanisms of AKI in COVID-19 and the challenges in managing fluid overload and acid-base imbalances in critically ill patients. The speakers also address the importance of a multidisciplinary team approach, optimal timing of RRT initiation, and the use of anticoagulation in COVID-19 patients. They emphasize the need for judicious and safe use of RRT based on individual patient characteristics and the availability of resources. Ultimately, the session provides insights into the management of COVID-19 patients with complex medical needs and the unique considerations for coordinating care in these cases.

Asset Subtitle

Procedures, 2021

Asset Caption

The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the 2021 Critical Care Congress held virtually from January 31-February 12, 2021.

Learning Objectives

Discuss the interplay of mechanical ventilator and dialysis machine in the management of life-threatening acidemia and volume overload
Identify special considerations when using extracorporeal membrane oxygenation (ECMO) and dialysis together, including circuit setup options and common pitfalls
Review practical multidisciplinary approaches for comanagement of patients with respiratory and kidney failure requiring treatment with a combination of mechanical ventilation and dialysis and, in some cases, ECMO
Summarize unique considerations for renal replacement therapy in COVID-19 patients, including infection control, anticoagulation, and contingency strategies during admission surges

Ventilation and Dialysis: Managing the Interplay
Raghavan Murugan

Circuit Overload: What to Do With ECMO Plus Dialysis
Dan Negoianu

COVID Plus RRT: Complexity Compounded
Rajit Basu

Meta Tag

Content Type Presentation

Knowledge Area Procedures

Knowledge Level Intermediate

Knowledge Level Advanced

Learning Pathway Skills and Procedures

Membership Level Select

Tag Dialysis

Tag Ventilation

Tag Extracorporeal Membrane Oxygenation ECMO

Year 2021

Keywords

COVID-19 patients

acute kidney injury

renal replacement therapy

mechanical ventilation

ECMO

dialysis

fluid overload

acid-base imbalances

multidisciplinary team approach

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