Start off the day at the Surgery meeting at the 7th floor meeting room. Today was a presentation about using extracorporeal devices in the management of ARDS with extrapulmonary involvement, in particular the use of ECMO (extracorporeal membrane oxygenation) and iLA (Interventional lung assist) in patients that have compromised lung function. I got a good review about the criteria of ARDS compared to acute lung injury. Both the advantages and limitations of using ECMO and iLA were presented. In regards to ECMO there is little to no support supporting its use as an effective treatment and the cost often limits its use. However as Taiwan national insurance pays for ECMO (very surprising as it is deemed expensive) it is often utilized as more a supportive care rather than treatment for patients that come in with ARDS and/or lung function compromise. At the meeting they explained that often the ECMO will be set up in the venous to venous (veno-venous ECMO) to bypass the heart as while ECMO can replace the heart when set up in Veno-arterial orientation, ECMO has not been shown to support the heart as it does support other organs in any format.
After the meeting Bor-Han and I received a mini-lecture from Dr. Kou about some common surgical procedures including hernia repair, and hemorrhoid management. Then we remained in the meeting room to practice suturing using gauze. Again pictures below:
Bor-Han suturing
Me suturing:
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