Perfusionist ECMO & NRP specialist ๐Ÿซ๐Ÿซ˜๐Ÿซ€ & ๐Ÿ–ฅ๏ธ POCUS ๐Ÿช‘Chair Normothermic Regional Perfusion EuroELSO WG ๐Ÿ“ฑ#SoMe Director @ELSOOrg/SoMe Editor @asaiojournal

Italy
Joined February 2011
TA #NRP in cDCD heart donors using closed #ECMO circuit, modified to provide ๐Ÿฉธ๐ŸŒก๏ธeffective NRP despite prolonged fWIT ๐Ÿซ€LV venting ๐Ÿซ€ fast conversion to central configuration as needed โญ•๏ธ shunt for recirculation ๐Ÿซง air management #FOAMcc @asaiojournal ๐Ÿ”“bit.ly/TANRPasaio TA-NRP using fully mobile, closed #ECLS circuit could be safe strategy to support combined thoracic/abdominal organs recovery also in peripheral centers without cardiac surgery program, contributing to the expansion of DCD programs, increasing availability/quality of grafts, improving recipientsโ€™ outcome. @ESOTtransplant @gabriel_oniscu @LuPoten @Unibo @AUSLRomagna
3
32
1
90
15,451
Pharmacology of vasopressors & inotropes during #ECMO ๐Ÿซ€hemodynamic dysregulation ๐Ÿฉธunique considerations during #ECLS: in-parallel circulation + afterload mismatch, concomitant circulatory devices + unloading ๐Ÿ’‰ catecholamines & derivatives ๐Ÿ’‰ non-catecholamines #FOAMcc #FOAMecmo ๐Ÿ”“ rdcu.be/MZ5Q1syp79Ua
23
79
3,315
๐Ÿ“ข Call for abstracts! Submit original research for 1st @ISOPPT Congress. Relevant clinical, translational, scientific and engineering work may be considered for oral or poster presentation. Among the categories: ๐Ÿซ€๐Ÿซ Thoracic & ๐Ÿซ˜ Abdominal organs ๐Ÿฉธ Artificial organ support systems ๐Ÿ”ฌ Bioengineering & mechanical engineering ๐Ÿ’‰ Drug testing ๐Ÿ” Research models & more... Submit now ๐Ÿ–Š๏ธ bit.ly/3UHJI4c Join us to discuss about hypo & normothermic machine perfusion, viability assessment, #AI, abdominal & thoraco-abdominal normothermic regional perfusion, immunomodulation, cold static preservation & cryopreservation/supercooling, #extracorporeal supporting devices... Save the date: ๐Ÿ“† February 19-20, 2027 ๐Ÿ“Œ Turin, Italy ๐Ÿ‡ฎ๐Ÿ‡น
2
3
461
๐Ÿ“ข Reducing anticoagulation in #ECMOโ‰๏ธ Here's the upcoming #EuroELSOwebinar ๐ŸŽค moderated & introduced by Mark Davidson & Nina Buchtele Speakers: ๐Ÿ’ก๐Ÿ”ฌ Becoming an early career researcher in #ECLS - Walter van den Bergh & Olivier van Minnen ๐ŸฉธStandard-dose unfractionated heparin versus low-dose unfractionated heparin and low-molecular-weight heparin in extracorporeal life support (RATE): an open-label, randomised, non-inferiority trial ... & lot of Q/A and discussion! Join us: ๐Ÿ“† October 27 2026 โฐ 16:00-17:30 CET Save the date & register now! ๐Ÿ–‹ euroelso.net/webinars/ ๐ŸŽฅ PS all previous @EuroELSO webinars are available on demand, free open access enjoy! #FOAMcc #FOAMecmo ๐Ÿ”“ bit.ly/EuroELSOyoutube
8
31
2,010
Acute Pulmonary Embolism 2026 Guidelines, an expert perspective including statements on: ๐Ÿซ€VA #ECMO & #ECPR as #MCS for patients exhibiting fulminant RV failure resulting in profound refractory cardiogenic shock or impending cardiac arrest ๐Ÿฉธadvanced reperfusion strategies in patients already supported by VA #ECLS ๐Ÿซ€ alternative percutaneous right ventricular assist devices to provide targeted RV support ๐Ÿ–‡๏ธ bit.ly/3W3fWY0
1
14
58
2,683
I had the opportunity to run a workshop on how to implement normothermic regional perfusion in DCD donors, sharing some tips & trick (from the perfusionist perspective) in beautiful Innsbruck ๐Ÿ‡ฆ๐Ÿ‡น! It was a pleasure engaging in an extremely interactive (& challenging) discussion with the outstanding team of Tirol Kliniken. Impressive to experience the exponential growth of the utilization #NRP throughout Europe (& beyond...), allowing for the expansion of DCDDs enrollment in procurement programs!
3
551
Hot Topics ๐ŸŒก๏ธ in ECMO #ELSO2026 session ๐Ÿซ€ ECPR in the geriatric population ๐Ÿ‘ Artificial womb technology for extreme prematurity ๐Ÿš‘ #ECPR ON-Scene Trial ๐Ÿ’งLiquid ventilation on ECMO โš ๏ธ Contraindications?? No more! Virtual program of 37th Annual @ELSOOrg conference is live!! (both pre & main conference). Register as virtual attendee at ๐ŸŽฅ bit.ly/4rUws8A If you joined in Nashville visit: ๐ŸŽฅ bit.ly/4ASyWZh
9
16
1,753
M Velia Antonini retweeted
New in ASAIO Journal. We imaged microcirc before & during Impella 5.5 support in 18 cardiogenic shock patients. Impaired baseline MFI, PPV, and PVD improved w Impella. Preserved values did not change. Perhaps pts with HD discordance may benefit most? doi.org/10.1097/MAT.00000000โ€ฆ
1
2
1
5
594
Recovery & survival in VA #ECMO for cardiogenic shock: may lactate normalization, as reflection of metabolic recovery, provide additional prognostic value vs static markers of initial disease severity?? ๐Ÿฉธ lactate normalization associated with higher rate of favorable neurologic discharge + 12 months survival This time-dependent threshold can be used to assist in early neuroprognosis + to guide decision-making on #MCS treatment. @asaiojournal ๐Ÿ–‡๏ธ bit.ly/4irdnHS
12
23
1,507
Expert analysis for cardiothoracic anesthesia & critical care @EACTS @STS_CTsurgery @AATSHQ guidelines on temporary #MCS in adult cardiac surgery: โฐ from deterioration to support: activation, candidacy, timing ๐Ÿซ€ protected cardiac surgery + failure to wean from CPB ๐Ÿฉบ physiology-matched device and configuration selection: #IABP, VA #ECMO & LV unloading, microaxial flow pumps, temporary LV & RV assist device, OxyRVAD, and biventricular support, combined/staged support ๐Ÿ–ฅ๏ธ anesthesia, implantation, and periprocedural monitoring ๐Ÿ–ฅ๏ธ intensive care: verify intended support and prevent secondary injury ๐Ÿซ€ recovery, weaning, transition, transport, explantation ๐Ÿ“– evidence interpretation and practice implications ๐Ÿ”ฎ knowledge gaps and future directions ๐Ÿ–‡๏ธ bit.ly/47oWuaF
18
37
1,858
Wondering how to deliver #CRRT during #ECMO? Best practices by the Joint ADQI & @ELSOOrg Consensus Conference on ECMO, AKI, Fluid Management & CRRT are out! ๐Ÿ“‹ institutional standards required for delivery ๐Ÿ”ง technical considerations #ECMO โš ๏ธ factors guiding integration of CRRT into ECMO circuit vs use of separate vascular access sites ๐Ÿ”‘ key performance indicators ๐Ÿฉธ factors guiding choice of anticoagulation Open access #FOAMcc #FOAMecmo ๐Ÿ”“ bit.ly/4hLY0K2
16
35
2,063
Cannulas are direct/indispensable interface between patients & #ECMO but may also cause severe side-effects, as thrombosis and hemolysis! Simulation study evaluating impact of drainage cannulas design ๐Ÿฉธ current design reveals no-flow/stagnation areas, which may induce thrombosis, especially if EBF <2LPM ๐Ÿฉธ largest proportion of flow drains through proximal row of holes = risk area for hemostasis distal โš™๏ธ new geometric design improved pressure loss, but at the expense of pronounced distal no-flow zones โš™๏ธ geometry of side holes has an important impact: distal growth of hole area results improved flow @ICMexperimental ๐Ÿ”“ rdcu.be/jMXLG1avSyoa
11
32
1,927
Prognostic implications of complications during veno-arterial #ECLS for cardiogenic shock ๐Ÿ” ELSO Registry analysis including > 22.5K adults ๐Ÿชฆ 54% patients died during hospitalization; 74% non-survivors vs 54% survivors experienced complications ๐Ÿง  neuro complications increased mortality by 3.6 Complications on VA #ECMO have a significant and cumulative effect on on survival. Absolute 30-day risk of mortality greater if a complication occurred, increasing from 48.6% (0 complications) to 93.1% with neurologic complication. Neurologic and pulmonary complications associated with greatest risk ๐Ÿ–‡๏ธ bit.ly/4dxaHWu
1
9
1
22
1,115
Pulmonary arterial pressure in VA #ECMO for patients with acute cardiogenic shock? ๐Ÿ” @ELSOOrg Registry analysis ๐Ÿ–ฅ๏ธ invasive hemodynamic status assessed at 24h PAC use alone not associated with lower mortality, but helped assess hemodynamic variables associated with lower mortality. Higher PAD at 24h significantly associated with graded increase in mortality, including if concomitant LV mechanical unloading (no significant difference in ealry PAD according to concomitant LVMU modality). Early on-support PAD potentially important hemodynamic marker during VA #ECLS. ๐Ÿ–‡๏ธ bit.ly/4hH8ysu
2
18
39
2,131
Acute Kidney Injury after initiating #ECMO in children: ๐Ÿ” cohort study; 284 neo/peds patients requiring #ECLS at a quaternary hospital in ๐Ÿ‡บ๐Ÿ‡ธ (80% VA, 20% VV) ๐Ÿซ˜ AKI classified as early if diagnosed โ‰ค 48hr after cannulation, late if > 48hr; transient if lasting < 48hr, persistent if > 48hr Persistent AKI frequent and independently associated with major adverse kidney events at 30 days (MAKE30); no association identified in patients with transient AKI. @PedCritCareMed ๐Ÿ–‡๏ธ bit.ly/4djcWN1 ๐Ÿซ˜ Coming with editorial: Do #AKI phenotypes MAKE a difference in #ECMO? ๐Ÿ–‡๏ธ bit.ly/3VwivBF
3
589
๐Ÿ… I received the biggest honour of an #ECMOlogist career, being appointed as Fellowship of the Extracorporeal Life Support Organization. Pleased that the work in ECMO education and training, and in the field of DCD organ donation and Normothermic Regional Perfusion, have been among the motivations underlying this designation, recognizing an extraordinary contributions to the art and science of #ECMO and #ECLS. I would like to thank the ELSO Leadership, particularly President Daniel Brodie, the Board of Directors, the CEO @stead_christine, Peter Rycus & the whole team, @DrGilesPeek, quintessential of ECMOlogy, and all the ELSO family. I am grateful for you welcoming me many years ago, and for the trust and the confidence you had/have in my potential. I am overwhelmed, well aware of both the prestige and responsibility coming with this (undeserved) award. Standing on the shoulder of giants.
10
2
1
62
4,153
M Velia Antonini retweeted
๐Ÿ”„ The countdown starts now! In exactly ๐—ผ๐—ป๐—ฒ ๐˜†๐—ฒ๐—ฎ๐—ฟ, the international transplantation community will come together under the theme โ€˜๐™ˆ๐™š๐™ฃ๐™จ ๐™š๐™ฉ ๐™ˆ๐™–๐™˜๐™๐™ž๐™ฃ๐™– โ€“ ๐—›๐˜‚๐—บ๐—ฎ๐—ป-๐—–๐—ฒ๐—ป๐˜๐—ฟ๐—ฒ๐—ฑ ๐—ง๐—ฟ๐—ฎ๐—ป๐˜€๐—ฝ๐—น๐—ฎ๐—ป๐˜๐—ฎ๐˜๐—ถ๐—ผ๐—ป ๐—ถ๐—ป ๐—ฎ๐—ป ๐—”๐—œ ๐—ช๐—ผ๐—ฟ๐—น๐—ฑโ€™: ๐Ÿ“ Prague ๐Ÿ“… 26-29 Sep 2027 ๐Ÿ”— go.esot.org/c27_home #ESOTcongress #MensEtMachina #PoweredByESOT
1
3
496
Membrane lung dead space in #ECMO: any relationship with functional impairment?? ๐Ÿ” pilot study including 27 ECMO circuits from 20 adults with acute respiratory failure. ๐Ÿงฎ ML dead space (MLDS) calculated from ML exhaust CO2 + blood gas measurements, and used to assess ML effectiveness/need for circuit exchange ๐Ÿ“ฆ 10 circuits required replacement; replaced circuits showed higher dead space + lower CO2 in ML exhaust gas + membrane lung CO2 removal vs circuits that completed run (with similar oxygenation-related measures/baseline characteristics) MLDS could be associated with conventional ML performance indicators (as resistances), contributing to a better understanding of ML physiology. MLDS thresholds associated with failure to be defined. Open access #FOAMcc #FOAMecmo ๐Ÿ”“ bit.ly/4yUDVqr
4
7
859
The (influential) role of regret in #ECMO candidacy decision-making ๐Ÿ” secondary analysis of qualitative semi-structured interview study w #ECLS international clinicians from urban, rural, public, private centers, Sep-Dec 2024 Three themes identified: 1๏ธโƒฃ clinicians prefer utility-based reasoning: often not possible 2๏ธโƒฃ regret of omission & commission both influence candidacy decisions 3๏ธโƒฃ clinicians employ various strategies to minimize past + anticipated regret This may partly explain known inconsistencies in candidacy decisions within centers. @accpchest ๐Ÿ–‡๏ธ bit.ly/3TeJ5yt
FRESH OFF THE PRESSES from our lab (๐Ÿ”—rubin-lab.mgh.harvard.edu/) How does anticipated regret influence ECMO candidacy decision-making? With a team including economists, we apply Regret Theory to analyze this question and demonstrate its role in ECMO candidacy. Clinicians prefer clear-cut cases, but even then, and certainly in more gray-zone cases, fear of regret emerges: 1โƒฃ Regret of omission: Even if we know ECMO won't help, we will feel terrible for not trying. 2โƒฃ Regret of commission: Even if there's a chance ECMO will help, it's very small and we will almost certainly regret having tried when this inevitably becomes a bridge to nowhere. Many questions follow: Is regret-dominated decision-making ever appropriate? Should it be corrected for? Does it exist across critical care or medicine more broadly? This is only the beginning journal.chestnet.org/articleโ€ฆ Thank you to Boston College Economics (@bc_econ) and @accpchest @journal_CHEST @MGBResearchNews @HMSbioethics @MGHHeartHealth @MGHHeartHealth @PCCSM_BIDMC @MGH_PCCM @HarvardPulm
2
9
1,764