Dr Vinodh Nanjayya
Dr Vinodh B Nanjayya is a Senior Intensive Care Specialist and Head of Cardiothoracic ICU at the Alfred Hospital. After becoming the fellow of the College of Intensive Care Medicine (CICM), he completed a fellowship in Critical Care Echocardiography from the Alfred ICU. He holds DDU (Critical Care) and a Masters in Biostatistics. His main areas of clinical expertise is in the ICU management of patients with mechanical cardiac support devices (extracorporeal membrane oxygenation, ventricular assist devices and Impella®), post heart and lung transplantation, and complex cardiac surgery. He is a current examiner for the College of Intensive Care Medicine (CICM) Fellowship examination and the Diploma of Diagnostic Ultrasound (Critical Care). He has been an active member of the CICM ultrasound special interest group. He is the main convenor of the echocardiography courses (basic, advanced, and trans-oesophageal echocardiography) run by the Alfred ICU and regularly teaches in many courses conducted by the Alfred ICU. He has conducted and published research in post-cardiac arrest, Extracorporeal Cardiopulmonary resuscitation, the agreement between arterial and venous blood gases in ICU and utility of intensivist performed deep vein thrombosis screening using ultrasound in ICU. He has presented in both national as well as international conferences on topics related to critical care echocardiography and Extracorporeal membrane oxygenation. He has co-authored guidelines for the Extracorporeal Life Support Organisation on ultrasound guidance for extracorporeal membrane oxygenation (ECMO).
When the ECMO alarms: bring me the ultrasound
Echocardiography plays a vital role in the management of patients on Extra-corporeal membrane oxygenation (ECMO). Behind every successful ECMO programme, there needs to be a robust echocardiography team with ICU physicians well versed in ECMO physiology and interpretation of imaging in the clinical context. By providing both structural and haemodynamic information, echocardiography assists in troubleshooting ECMO alarms. Based on the adequacy of the transthoracic acoustic window, either transthoracic or trans-oesophageal echocardiography can be used. Echocardiography is critical in patient selection, cannulation, evaluation of complications like shock or access insufficiency, and weaning. This talk will review the role of echocardiography in troubleshooting ECMO alarms using commonly encountered scenarios while managing patients on ECMO in intensive care units.