Course Syllabus
Obiettivi
Il corso ha lo scopo di sviluppare negli studenti del corso di laurea in infermieristica le conoscenze riguardanti l’utilizzo del supporto Ecmo Veno-Arterioso nelle emergenze-urgenze intra ed extraospedaliere.
Nello specifico gli obiettivi del corso si orientano a:
Approfondire le conoscenze sulle principali indicazioni al posizionamento di un supporto ecmo veno-arterioso
Riconoscere le principali diagnosi infermieristiche, gli interventi ed outcomes nella persona sottoposta ad ecmo veno-arterioso
Conoscere l’organizzazione del team mutlidisciplinare nella presa in carico della persona in ecmo veno-arterioso
Contenuti sintetici
Cenni storici e definizione del supporto ecmo
Fisiologia di base dell’ecmo v-a, indicazioni cliniche, criteri di inclusione
Principali complicanze
Presa in carico della persona in supporto ecmo v-a
Attivazione, protocolli e team work
Stato dell’arte e ricerca, considerazioni etiche
Programma esteso
Conoscenza delle principali indicazioni e controindicazioni al posizionamento di un supporto dell’ECMO V-A
Fisiologia di base dell’ECMO V-A, indicazioni cliniche, criteri di inclusione
Tecniche di funzionamento dell’ECMO V-A
Esposizione di un caso clinico di posizionamento ECMO V-A in emergenza
Presa in carico paziente in ECMO V-A: nursing, monitoraggio, trasporto e complicanze
Svezzamento da ECMO V-A o bridge to VAD/trapianto
Stato dell’arte e ricerca, considerazioni etiche
Prerequisiti
Iscrizione al terzo anno di Corso di Laurea in Infermieristica
Modalità didattica
La lezione si svolge in modalità erogativa in presenza attraverso lezione frontale e discussione guidata.
Materiale didattico
Richardson, A. S. C., Tonna, J. E., Nanjayya, V., Nixon, P., Abrams, D. C., Raman, L., Bernard, S., Finney, S. J., Grunau, B., Youngquist, S. T., McKellar, S. H., Shinar, Z., Bartos, J. A., Becker, L. B., Yannopoulos, D., Bˇelohlávek, J., Lamhaut, L., & Pellegrino, V. (2021). Extracorporeal Cardiopulmonary Resuscitation in Adults. Interim Guideline Consensus Statement From the Extracorporeal Life Support Organization. ASAIO journal (American Society for Artificial Internal Organs : 1992), 67(3), 221–228.
Ubben, J. F. H., Heuts, S., Delnoij, T. S. R., Suverein, M. M., van de Koolwijk, A. F., van der Horst, I. C. C., Maessen, J. G., Bartos, J., Kavalkova, P., Rob, D., Yannopoulos, D., Bělohlávek, J., Lorusso, R., & van de Poll, M. C. G. (2023). Extracorporeal cardiopulmonary resuscitation for refractory OHCA: lessons from three randomized controlled trials-the trialists' view. European heart journal. Acute cardiovascular care, 12(8), 540–547.
Rao, P., Khalpey, Z., Smith, R., Burkhoff, D., & Kociol, R. D. (2018). Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest. Circulation. Heart failure, 11(9), e004905.
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O'Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468.
Lorusso, R., Shekar, K., MacLaren, G., Schmidt, M., Pellegrino, V., Meyns, B., Haft, J., Vercaemst, L., Pappalardo, F., Bermudez, C., Belohlavek, J., Hou, X., Boeken, U., Castillo, R., Donker, D. W., Abrams, D., Ranucci, M., Hryniewicz, K., Chavez, I., Chen, Y. S., … Whitman, G. (2021). ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients. ASAIO journal (American Society for Artificial Internal Organs : 1992), 67(8), 827–844.
Belohlavek, J., Smalcova, J., Rob, D., Franek, O., Smid, O., Pokorna, M., Horák, J., Mrazek, V., Kovarnik, T., Zemanek, D., Kral, A., Havranek, S., Kavalkova, P., Kompelentova, L., Tomková, H., Mejstrik, A., Valasek, J., Peran, D., Pekara, J., Rulisek, J., … Prague OHCA Study Group (2022). Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA, 327(8), 737–747.
Abrams, D., Garan, A. R., Abdelbary, A., Bacchetta, M., Bartlett, R. H., Beck, J., Belohlavek, J., Chen, Y. S., Fan, E., Ferguson, N. D., Fowles, J. A., Fraser, J., Gong, M., Hassan, I. F., Hodgson, C., Hou, X., Hryniewicz, K., Ichiba, S., Jakobleff, W. A., Lorusso, R., … International ECMO Network (ECMONet) and The Extracorporeal Life Support Organization (ELSO) (2018). Position paper for the organization of ECMO programs for cardiac failure in adults. Intensive care medicine, 44(6), 717–729.
Periodo di erogazione dell'insegnamento
Secondo semestre
Orario di ricevimento
Su appuntamento
Sustainable Development Goals
Aims
The course aims to develop in the students of the nursing degree course the knowledge regarding the use of Ecmo Veno-Arterioso support in intra and extra-hospital emergencies.
Specifically, the course aims to:
• Deepen knowledge on the main indications to the positioning of an ecmo veno-arterious support
• Recognize the main nursing diagnoses, interventions and outcomes in the person undergoing veno-arterial ecmo
• Know the organization of the team mutlidisciplinare in taking charge of the person in ecmo veno-arterioso
Contents
Historical background and definition of ecmo support
• Basic ecmo v-a physiology, clinical indications, inclusion criteria
• Main complications
• Taking charge of the supporting person
• Activation, protocols and team work
• State of the art and research, ethical considerations
Detailed program
Knowledge of the main indications and contraindications to the positioning of an ECMO V-A support
• Basic physiology of ECMO V-A, clinical indications, inclusion criteria
• ECMO V-A operating techniques
• Exposure of a clinical case of ECMO V-A positioning in emergency
• Patient Management in ECMO V-A: Nursing, monitoring, transport and complications
• Weaning from ECMO V-A or bridge to VAD/transplantation
• State of the art and research, ethical considerations
Prerequisites
Enrolment in the third year of Degree in Nursing
Teaching form
The lesson takes place in the dispensing mode in presence through frontal lesson and guided discussion.
Textbook and teaching resource
Richardson, A. S. C., Tonna, J. E., Nanjayya, V., Nixon, P., Abrams, D. C., Raman, L., Bernard, S., Finney, S. J., Grunau, B., Youngquist, S. T., McKellar, S. H., Shinar, Z., Bartos, J. A., Becker, L. B., Yannopoulos, D., Bˇelohlávek, J., Lamhaut, L., & Pellegrino, V. (2021). Extracorporeal Cardiopulmonary Resuscitation in Adults. Interim Guideline Consensus Statement From the Extracorporeal Life Support Organization. ASAIO journal (American Society for Artificial Internal Organs : 1992), 67(3), 221–228.
Ubben, J. F. H., Heuts, S., Delnoij, T. S. R., Suverein, M. M., van de Koolwijk, A. F., van der Horst, I. C. C., Maessen, J. G., Bartos, J., Kavalkova, P., Rob, D., Yannopoulos, D., Bělohlávek, J., Lorusso, R., & van de Poll, M. C. G. (2023). Extracorporeal cardiopulmonary resuscitation for refractory OHCA: lessons from three randomized controlled trials-the trialists' view. European heart journal. Acute cardiovascular care, 12(8), 540–547.
Rao, P., Khalpey, Z., Smith, R., Burkhoff, D., & Kociol, R. D. (2018). Venoarterial Extracorporeal Membrane Oxygenation for Cardiogenic Shock and Cardiac Arrest. Circulation. Heart failure, 11(9), e004905.
Panchal, A. R., Bartos, J. A., Cabañas, J. G., Donnino, M. W., Drennan, I. R., Hirsch, K. G., Kudenchuk, P. J., Kurz, M. C., Lavonas, E. J., Morley, P. T., O'Neil, B. J., Peberdy, M. A., Rittenberger, J. C., Rodriguez, A. J., Sawyer, K. N., Berg, K. M., & Adult Basic and Advanced Life Support Writing Group (2020). Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 142(16_suppl_2), S366–S468.
Lorusso, R., Shekar, K., MacLaren, G., Schmidt, M., Pellegrino, V., Meyns, B., Haft, J., Vercaemst, L., Pappalardo, F., Bermudez, C., Belohlavek, J., Hou, X., Boeken, U., Castillo, R., Donker, D. W., Abrams, D., Ranucci, M., Hryniewicz, K., Chavez, I., Chen, Y. S., … Whitman, G. (2021). ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients. ASAIO journal (American Society for Artificial Internal Organs : 1992), 67(8), 827–844.
Belohlavek, J., Smalcova, J., Rob, D., Franek, O., Smid, O., Pokorna, M., Horák, J., Mrazek, V., Kovarnik, T., Zemanek, D., Kral, A., Havranek, S., Kavalkova, P., Kompelentova, L., Tomková, H., Mejstrik, A., Valasek, J., Peran, D., Pekara, J., Rulisek, J., … Prague OHCA Study Group (2022). Effect of Intra-arrest Transport, Extracorporeal Cardiopulmonary Resuscitation, and Immediate Invasive Assessment and Treatment on Functional Neurologic Outcome in Refractory Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA, 327(8), 737–747.
Abrams, D., Garan, A. R., Abdelbary, A., Bacchetta, M., Bartlett, R. H., Beck, J., Belohlavek, J., Chen, Y. S., Fan, E., Ferguson, N. D., Fowles, J. A., Fraser, J., Gong, M., Hassan, I. F., Hodgson, C., Hou, X., Hryniewicz, K., Ichiba, S., Jakobleff, W. A., Lorusso, R., … International ECMO Network (ECMONet) and The Extracorporeal Life Support Organization (ELSO) (2018). Position paper for the organization of ECMO programs for cardiac failure in adults. Intensive care medicine, 44(6), 717–729.
Semester
Second semester
Assessment method
Frequency
Office hours
By appointment
