Abstract
‘It isn’t what we say or think that defines us, but what we do’
Jane Austen – Sense and Sensibility: English novelist known primarily for her six major novels, which interpret, critique and comment upon the British landed gentry at the end of the 18th century. Austen’s plots often explore the dependence of women on marriage in the pursuit of favourable social standing and economic security. Born: December 1775 – Died: July 1817
Quite rightly saying ‘are we there yet’ will need to be repeated many times, it will be a long journey to get vaccinations throughout the world. The vaccination journey begins locally, regionally, nationally, and only ends when internationally everyone on planet Earth has been vaccinated. Our deepest sympathies to families losing their near and dear ones everywhere and sincerely hope we can all overcome this unseen foe especially in India.
We have to encourage vaccination, get first dose, second dose and continue to take precautions even if we have been vaccinated. Masks can only come off if everyone is vaccinated and even if we are vaccinated, we could carry the virus to pass on to an individual who can develop a significant illness until we have either vaccinated all or have herd immunity. We are not there yet and still need to be vigilant, take precautions, maintain safe distancing, wash hands and wear masks.
A new ‘NORMAL’ never imagined before is certain because even if we overcome the viral pandemic, we may have to deal with the long-term consequences ‘Long Covid’ for a very long time in the new ‘Normal’.
Science must carry on and once again my congratulations to authors who have persisted not just for the management of Covid 19 with or without ECMO but also continue their quest to enlighten us for the management of various other conditions.
We start with Gregoric et al.’s experience of inter-hospital COVID ECMO air transportation expertly commented by Kevin Charette to understand the feasibility and experience. ECMO use has expanded exponentialy and we learn more by sharing our experience and knowledge to lateralise not just in Covid 19 but expand indications too. Covid 19 forced us to utilise every resource, expand our knowledge base, experience and sharing this paramount.
Gianni Angelini and colleagues have embarked on an important trail, ‘COMICS’ trial which compares conventional versus minimally invasive extracorporeal circulation in patients undergoing cardiac surgery and present their protocol for this study. It is hoped that there will be beneficial difference of incorporating minimally invasive extracorporeal circulation which can then be expanded to minimally invasive cardiac surgery. Shikata’s manuscript on regional oxygen saturation change rate for detection of leg ischaemia and minimally invasive cardiac surgery is an important contribution supplementing that along with Kofidis’ manuscript of alternative technique of long acting cardioplegia delivery resulting in less haemodilution. With these manuscripts we educate ourselves towards a better understanding of minimally invasive extracorporeal circulation as well as minimally invasive cardiac surgery, finally the effects of bleeding and the effect of anti-thrombin in fresh frozen plasma and haemostasis after cardiopulmonary bypass surgery by Shirozu complements this understanding.
Harky’s comprehensive literature review on myocardial protection techniques in cardiac surgery highlights the limitations in options and gives us an overview worth reading.
Mohamed et al. evaluate pre-operative C-reactive protein as a predictor of postoperative acute kidney injury in patients undergoing cardiac surgery coupled with our understanding of minimally invasive extracorporeal circulation and findings of minimally invasive surgery makes this issue an educational review.
In the meantime, we continue to explore ECMO not just in COVID but also in severe acute respiratory distress syndrome supported by veno-venous ECMO with Xu’s manuscript on individualised positive and expiratory pressure setting.
I hope that you are all safe, well and vaccinated or proceeding to vaccination and encouraging everyone for vaccination. My congratulations and gratitude to all authors.
I would also like to take this opportunity to welcome EuroELSO members joining our newly formed EuroELSO Editorial Board. The four new members are Christoph Benk, University Hospital Freiburg, Germany, Mirko Belliato, Foundation IRCCS Policlinico San Matteo, Italy, Nicholas Barrett, Guy’s and St Thomas’ NHS Foundation Trust, UK and Pete Roeleveld, Leiden University Medical Center, The Netherlands.
We look forward to a fruitful and constructive collaboration
Thank You