Advanced Techniques of Perfusion and Extracorporeal Life-Support

A.Y. 2021/2022
5
Max ECTS
50
Overall hours
SSD
MED/11 MED/23 MED/50
Language
Italian
Learning objectives
- To acquire the principles of pathophysiology and learn about the etiopathogenesis of cardiovascular decompensation
- To know and acquire cardiorespiratory resuscitation techniques
- To acquire knowledge on the characteristics of hemodynamic and cardiac support devices
- Know the principles of pathophysiology of cardiovascular and cardiorespiratory support
Expected learning outcomes
- Know the principles of pathophysiology and learn about the etiopathogenesis of cardiovascular failure
- Know the hemodynamic support devices, their characteristics and their indications
- Know in detail the management of cardio circulatory and cardiorespiratory support techniques
Course syllabus and organization

Single session

Responsible
More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Prerequisites for admission
No prior knowledge is required
Assessment methods and Criteria
The exam will be written. It will mainly consist of multiple choice questions with the addition of some open questions, in addition it will be possible, at the discretion of the teacher, to carry out an additional oral test.
Physiopathology of heart failure
Course syllabus
Definition and pathophysiology of heart failure: Terms for the description and definition of heart failure.
Etiology and Pathophysiology of heart failure
Symptoms and signs: Symptoms and signs of congestion.
Physical symptoms and signs resulting from inadequate tissue perfusion.
Symptoms and Severity: Classification of decompensation according to the New York Heart Association (NYHA).
Non-invasive and invasive investigations: Laboratory tests to be performed in patients with symptoms or signs of heart failure.
Neurohormonal evaluation.
ECG in heart failure.
ECG Holter. Chest X-ray. Lung function. Echocardiography. Nuclear cardiology. Cardiopulmonary stress test. Diagnostic imaging after stress. Right and left catheterization, coronary angiography.
Treatment of advanced heart failure: Health education, drug therapy and devices.
Pre and post cardiac transplant assistance: Cardiac transplant indication, requirements, absolute and relative contraindications, laboratory and instrumental screening, transplant list insertion. Organ assignment: criteria, receiving status. Diagnostic-therapeutic and care protocols aimed at systematic monitoring of clinical conditions and identification of early and late complications. Systemic and transplant organ complications. Etiology of systemic complications. Graft vasculopathy. Survival after transplant. Quality of life after transplantation.
Teaching methods
The courses will include lectures with the possible addition of laboratory exercises
Teaching Resources
Harrison's Principles of Internal Medicine, 20e
Part 6: Disorders of the Cardiovascular System
J. Larry Jameson, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, Dan L. Longo, Joseph Loscalzo
Mechanical circulatory support devices
Course syllabus
Circulatory assistance: intraortic counterpulsation
Short-term assistance
Non-pulsatile systems:
Roller pump centrifuge
Axial pumps
Pulsatile systems
Long-term care: Electromechanical VADs VAD pneumatic and hydraulic Assistance to the patient with VAD
Teaching methods
The courses will include lectures with the possible addition of laboratory exercises
Teaching Resources
Mora - Cardioplumonary Bypass
Applied medical techniques
Course syllabus
Classification of cardio-circulatory and / or mechanical respiratory assistance
The history of assistance with particular reference to the E.C.M.O.
Indications
Indications to the E.C.M.O.heart disease in neonatal age with particular reference to assistance in patients with univentricular heart physiology
Indications to the E.C.M.O. heart disease in adulthood
Indications to the E.C.M.O. respiratory in neonatal age
Indications to the E.C.M.O. respiratory in children
Indications to the E.C.M.O. respiratory in adulthood
Cannulas and cannulation Materials for E.C.M.O.
Tubes pumps Oxygenator Devices and accessories Management of the E.C.M.O.
Step 1: anamnesis
Step 2: analysis of the materials used
Step 3: patient, circuit management and correct compilation of the file
Step 4: Check list management
Step 5: Technical report of the circuit
Step 6: patient management in E.C.M.O. awake and spontaneously breathing
Step 7: management of the child in E.C.M.O.
Emergency and accident management
Transporting the patient to E.C.M.O.
Hemofiltration / Dialysis in E.C.M.O.
Cardiac transplant of the patient in E.C.M.O.
Lung transplantation of the patient in E.C.M.O.
Analysis of recent literature
Teaching methods
The courses will include lectures with the possible addition of laboratory exercises
Teaching Resources
MORA - Cardioplumonary Bypass
The Journal of ExtraCorporeal Technology - American Society of Extra-Corporeal Technology
Costantine Mavroudis Carl L. Backer - Pediatric Cardiac Surgery -- 3rd Edition
ELSO-Red book - 3rd Edition
Applied medical techniques
MED/50 - APPLIED MEDICAL TECHNOLOGY AND METHODOLOGY - University credits: 2
Lessons: 20 hours
Mechanical circulatory support devices
MED/23 - HEART SURGERY - University credits: 2
Lessons: 20 hours
Physiopathology of heart failure
MED/11 - CARDIOVASCULAR DISEASES - University credits: 1
Lessons: 10 hours