Course Syllabus

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Il corso è finalizzato a fornire agli studenti del Corso di Laurea in Infermieristica una solida preparazione teorico-pratica sull’utilizzo del supporto ECMO veno-arterioso (VA) nelle situazioni di emergenza-urgenza, sia intraospedaliere che extraospedaliere.

In particolare, il corso si propone di:

  1. Conoscenza e comprensione: Approfondire le conoscenze relative alle principali indicazioni cliniche per l’attivazione e il posizionamento di un supporto ECMO VA. Comprendere i principi di funzionamento della tecnica ECMO e il suo impatto fisiopatologico sul paziente.
  2. Applicazione della conoscenza e capacità di comprensione: Riconoscere le principali diagnosi infermieristiche associate alla gestione del paziente in ECMO VA. Identificare e applicare gli interventi infermieristici più appropriati e monitorare gli outcome clinico-assistenziali.
  3. Autonomia di giudizio: Sviluppare la capacità di raccogliere, interpretare e valutare dati clinico-assistenziali relativi alla persona in ECMO VA, formulando giudizi critici e autonomi. Considerare le implicazioni etiche, organizzative e relazionali nell’ambito dell’assistenza al paziente in ECMO.
  4. Abilità comunicative: Acquisire competenze comunicative efficaci per interagire in modo professionale con il team multidisciplinare coinvolto nella gestione del paziente in ECMO. Essere in grado di trasmettere informazioni cliniche in modo chiaro e appropriato sia a interlocutori specialisti che non specialisti (familiari, caregiver, ecc.).
  5. Capacità di apprendere: Promuovere un approccio proattivo all’apprendimento continuo, favorendo l’aggiornamento delle competenze infermieristiche in relazione all’evoluzione delle tecnologie e dei protocolli di gestione ECMO.

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

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

Iscrizione al terzo anno di Corso di Laurea in Infermieristica

La lezione si svolge in modalità erogativa in presenza attraverso lezione frontale e discussione guidata.

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.

Secondo semestre

Frequenza

Su appuntamento

SALUTE E BENESSERE | ISTRUZIONE DI QUALITÁ
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The course aims to provide students of the Bachelor’s Degree in Nursing a solid theoretical and practical preparation on the use of veno-arterial (VA) ECMO support in emergency situations, both intra- and extra-hospital.

In particular, the course aims to:

  1. Knowledge and understanding: Deepen knowledge of the main clinical indications for the activation and positioning of an ECMO VA support. Understand the working principles of the ECMO technique and its pathophysiological impact on the patient.
  2. Application of knowledge and understanding ability: Recognize key nursing diagnoses associated with patient management in ECMO VA. Identify and apply the most appropriate nursing interventions and monitor clinical-care outcomes.
  3. Autonomy of judgement: Develop the ability to collect, interpret and evaluate clinical-care data related to the person in ECMO VA, formulating critical and autonomous judgements. Consider the ethical, organisational and relational implications of ECMO patient care.
  4. Communication skills: Acquire effective communication skills to interact professionally with the multidisciplinary team involved in patient management in ECMO. Be able to convey clinical information in a clear and appropriate manner to both specialist and non-specialist interlocutors (family members, caregivers, etc.).
  5. Ability to learn: Promote a proactive approach to lifelong learning, facilitating the updating of nursing skills in relation to the evolution of ECMO management technologies and protocols.

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

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

Enrolment in the third year of Degree in Nursing

The lesson takes place in the dispensing mode in presence through frontal lesson and guided discussion.

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.

Second semester

Frequency

By appointment

GOOD HEALTH AND WELL-BEING | QUALITY EDUCATION
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Key information

Field of research
NN
ECTS
1
Term
Annual
Activity type
Elective
Course Length (Hours)
8
Language
Italian

Staff

    Teacher

  • AA
    Alice Annoni

Students' opinion

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Bibliography

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Enrolment methods

Manual enrolments

Sustainable Development Goals

GOOD HEALTH AND WELL-BEING - Ensure healthy lives and promote well-being for all at all ages
QUALITY EDUCATION - Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all