SCCM Resource Library-When Guidelines Don't Help: Challenging Cases in Hematologic Management of Mechanical Support Devices

Video Transcription

Video Summary

The video features a virtual panel discussion on the challenges of managing hematologic complications in patients on mechanical support devices like ECMO. The experts emphasize the importance of personalized treatment plans and multidisciplinary collaboration in this context. They discuss the use of heparin as the most common anticoagulant, but mention that some centers have started using direct thrombin inhibitors. The panel highlights the need for ongoing research and the lack of clear guidelines in anticoagulation management for ECMO patients. They also touch on the feasibility and safety of performing surgeries at the bedside in ECMO patients, with appropriate anticoagulation adjustments. The speakers stress the importance of monitoring and intervention to find a balance between bleeding and clotting risks. They also mention the use of viscoelastic testing and other laboratory assays for treatment decisions. The challenges of managing anticoagulation in patients with stents are also discussed. The panel briefly addresses the topic of intracranial hemorrhage and the need for ongoing monitoring and collaboration in managing these complex patients. The video concludes with a call for continued research and collaboration to enhance outcomes for ECMO patients.

Asset Subtitle

Hematology, 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

Recognize key dilemmas in balancing anticoagulation and bleeding risk in patients on mechanical circulatory support
Weigh therapeutic options when dilemmas occur
Assess different perspectives in management and treatment among various disciplines

Case Presentation
Marie E. Steiner

Panel Discussion: Intensivist's Perspective
Subhasis Chatterjee

Panel Discussion: Surgeon's Perspective
Mark D. Cipolle

Panel Discussion: Pharmacist Perspective
William E. Dager

Case Presentation 1 Wrap-Up
Marie E Steine

Case Presentation 2
Marie E Steiner

Case Presentation 2: Intensivist's Perspective
Subhasis Chatterjee

Case Presentation 2: Surgeon's Perspective
Mark D. Cipolle

Case Presentation 2: Pharmacist's Perspective
Matthew R Wanek

Case Presentation 2: Wrap-Up
Marie E Steiner

Meta Tag

Content Type Presentation

Knowledge Area Hematology

Knowledge Area Procedures

Knowledge Level Advanced

Learning Pathway Skills and Procedures

Membership Level Select

Tag Anticoagulation

Tag Extracorporeal Membrane Oxygenation ECMO

Tag Surgery

Year 2021

Keywords

hematologic complications

mechanical support devices

ECMO

personalized treatment plans

multidisciplinary collaboration

heparin

direct thrombin inhibitors

anticoagulation management

ongoing research

bedside surgeries

anticoagulation adjustments

monitoring and intervention

viscoelastic testing

patients with stents

intracranial hemorrhage

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