Interview with Jeffrey DellaVolpe, MD

Why did you feel that it was important to write a book on this topic? What does your The ECMO Book, 1st Edition add to the field?   

While ECMO continues to grow throughout the world, saving more and more lives, there also seems to be a widening gap between experienced practitioners and those that care for these patients less frequently. I’ve found that this gap can lead to the care of patients on ECMO being viewed as unapproachable on one extreme and overly dogmatic on the other extreme. I wanted to write a book that could break down the rationale and mechanism of ECMO into accessible and understandable terms that could form a foundation for approaching these patients.  

What is the most exciting aspect of The ECMO Book, 1st Edition? What chapter or topic covered are you most excited about?   

I think one of the most challenging aspects of caring for patients on ECMO is the day-to-day management. This is because of the subtleties related to their care as well as the complex physiology at play. The entire second half of the book seeks to define this physiology as well as the complexities related to the management of patients on ECMO. I am excited about these sections because it is my hope that they can help practitioners improve the way they care for their patients at the bedside.  

Who will find the greatest value from The ECMO Book, 1st Edition and why?   

Readers who approach this book with an open mind and a genuine desire to translate these concepts to the care of their patients will find a lot of value in the book. The book aims to be less prescriptive and more conceptual, gradually building the framework for an increasingly refined approach to the care of patients on ECMO. This approach is important, not only as it relates to the concepts covered in the book, but also because it can hopefully extend past the book and give readers a mechanism to continue to improve with every patient encountered.  

Whether a reader has never seen a patient on ECMO or has cared for hundreds of patients, my hope is that this book will be of use and allow for a nuanced approach to their patients.  

What new ideas, practices, or procedures do you hope your readers take away from The ECMO Book, 1st Edition?   

First, I’d like to see readers take away an appreciation of the dose related toxicity of many of the interventions used in critical care and understand the role of ECMO in reducing this toxicity. I would also hope for readers to apply this concept to patient selection for ECMO. Finally, I would like for readers to come away with a sense of the unique physiology at play for patients on ECMO so that they could apply this knowledge to their patients.  

What problem do you hope the future generation of your specialty will be able to solve?   

I see critical care medicine as becoming an increasingly central component of inpatient care. Moreover, I think that as technology continues to improve, many of the modalities that are now managed in intensive care units, such as ventilators and titratable drips, will be managed outside of the ICU and even out of the hospital. Instead, I see critical care medicine evolving into the application of technology aimed at providing multimodal organ support. If our specialty can solve how to provide this organ support in a personalized manner while also emphasizing a focus on quality of life that is meaningful to the patient, I think we will serve our patients well in the years to come.  

Is there anything else about the book you’d like to say?   

Caring for patients in the ICU, especially those in severe cardiac and respiratory failure that could potentially need ECMO is not easy. Some of the most painful and yet some of the most rewarding experiences in my career have involved taking care of patients on ECMO. I don’t pretend that this book will make these experiences any easier, but what I do hope is that it will allow practitioners the opportunity to better care for their patients.  

About the Author

My name is Jeffrey DellaVolpe. I am a critical care physician and the Medical Director of the Adult ECMO Program for the Methodist Healthcare System in San Antonio, TX. Additionally, I serve as National Physician Director, Critical Care for HCA Healthcare, where I co-chair the ECMO Working Group. Prior to my current position, I was a critical care physician in the US Air Force.  

Purchase your copy of The ECMO Book, 1st Edition here!