Speakers
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Dr. Kai-Cheuk SIN
Hong Kong
Dr Sin is an intensive care specialist at Queen Elizabeth Hospital, with special interests in Circulatory Support and Neurocritical Care. He graduated from the Chinese University of Hong Kong, and is a fellow of the Hong Kong College of Physicians, Royal College of Physicians of Edinburg and Glasgow, and College of Intensive Care Medicine of Australia and New Zealand.
Having been trained at one of the Hong Kong’s ECMO referral centres, Dr Sin has gained extensive experience in managing critically ill patients with the use of ECMO therapy. He has been invited as the faculty of various ECMO training programmes organised locally and by the Extracorporeal Life Support Organization.
In addition to his clinical works, Dr Sin is also dedicated to medical simulation and professional health education. He is the advisory member of the Multi-Disciplinary Simulation & Skills Centre, and has been the co-director of Hospital Authority Central Intern Orientation Program and Intern Boot Camp since 2014.
Extracorporeal membrane oxygenation (ECMO) has become an emerging therapeutic modality in the management of critical ill patients with severe cardiac and respiratory failure. Among the different ECMO configurations, veno-arterial ECMO (VA-ECMO) provides circulatory support by bypassing both the heart and lungs. However, the hemodynamic consequences of VA-ECMO, particularly left ventricular (LV) distension, can pose significant challenges and require careful management.
This presentation aims to provide an overview of the basic principles of ECMO and delve into the hemodynamic and physiological aspects associated with LV distension during VA-ECMO. Understanding these concepts is crucial for optimizing patient outcomes and preventing complications.
The session will include a comprehensive discussion on various strategies for LV unloading. These strategies encompass both pharmacological interventions and mechanical approaches. Special emphasis will be placed on the ECpella strategy, which involves with placement of an Impella device to unload the LV while maintaining VA-ECMO support. Additionally, the concept of LAVA-ECMO will be explored as a mean to reduce LV distension and improve hemodynamic stability.
The presentation will include case scenarios that highlight the application of these strategies (ECpella and LAVA-ECMO). The outcomes and lessons learned from these cases will be shared to provide valuable insights into their potential benefits and challenges in managing patients with compromised LV function while on VA-ECMO.
By attending this session, participants will gain a comprehensive understanding of the hemodynamic management of patients on ECMO, with a specific focus on LV unloading strategies. The knowledge and experience shared will assist clinicians in optimizing patient care and improving outcomes in this complex patient group.
