<div dir="ltr">Hey all,<div> I just had a discussion with our ECMO director at URMC. He offered that when on ECMO they pay attention to "LV venting." This basically means that a static heart is prone to clot formation. For that reason they dont let the patient rest on ECMO circuitry alone, and they will continue patients on vasopressors as well as Impella devices. In the specific scenario of HIET, he offered that he would probably continue HIET at a dose reduction after starting ECMO so as to support some myocardial contractility. He tempered the entire discussion with the notion that he does not have experience with ECMO in the poisoned patient and extrapolates his thoughts based on ECMO in alternative scenarios.</div><div><br></div><div>NN</div></div><br><div class="gmail_quote"><div dir="ltr" class="gmail_attr">On Wed, Nov 15, 2023 at 11:00 AM Matthew Kolbeck <<a href="mailto:KolbeckM@upstate.edu">KolbeckM@upstate.edu</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left:1px solid rgb(204,204,204);padding-left:1ex"><div class="msg-2230277594530517117">
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<div style="font-family:Calibri,Arial,Helvetica,sans-serif;font-size:12pt;color:rgb(0,0,0)">
<span style="font-family:Arial,Helvetica,sans-serif">Matthew Kolbeck, MD</span></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif;font-size:12pt;color:rgb(0,0,0)">
<span style="font-family:Arial,Helvetica,sans-serif">Medical Toxicology Fellow</span></div>
<div style="font-family:Calibri,Arial,Helvetica,sans-serif;font-size:12pt;color:rgb(0,0,0)">
<span style="font-family:Arial,Helvetica,sans-serif">SUNY Upstate Medical University</span></div>
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<span style="font-family:Arial,Helvetica,sans-serif"><a href="mailto:kolbeckm@upstate.edu" target="_blank">kolbeckm@upstate.edu</a></span></div>
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</div></blockquote></div><br clear="all"><div><br></div><span class="gmail_signature_prefix">-- </span><br><div dir="ltr" class="gmail_signature"><div dir="ltr"><div>Nicholas E. Nacca, MD<br>Board Certified Emergency Medicine, Medical Toxicology & Addiction Medicine<br><br></div></div></div>