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Mechanical Ventilation During ECMO
- ECMO is a rapidly emerging therapy for critically ill patients with severe acute respiratory failure (VV-ECMO) and circulatory failure (VA-ECMO).
- Mechanical ventilation (MV) settings may have important effects on patients receiving either VV- or VA-ECMO.
- Though no large, randomized trials, consensus guidelines and expert opinion recommend the following initial settings for patients receiving VV-ECMO:
- Tidal volume: < 4 ml/kg predicted body weight
- Plateau pressure: < 25 cmH2O
- PEEP: 10-15 cmH2O
- FiO2: titrated to maintain sats > 85%
- RR: 4 to 6 breaths per minute
References
Schmidt M, et al. Mechanical ventilation during extracorporeal membrane oxygenation. Crit Care 2014;18:203.