Ventilator settings during veno-venous ECMO in ARDS patients.

Authors

  • Benjamin Pequignot Université de Lorraine, CHRU de Nancy, Médecine Intensive et Réanimation Brabois, INSERM U116, Nancy, France
  • Simon Valentin Université de Lorraine, CHRU de Nancy, Médecine Intensive et Réanimation Brabois, INSERM U116, Nancy, France
  • Bruno Lévy Université de Lorraine, CHRU de Nancy, Médecine Intensive et Réanimation Brabois, INSERM U116, Nancy, France
  • Antoine Kimmoun Université de Lorraine, CHRU de Nancy, Médecine Intensive et Réanimation Brabois, INSERM U116, Nancy, France
  • Matthieu Koszutski Université de Lorraine, CHRU de Nancy, Médecine Intensive et Réanimation Brabois, INSERM U116, Nancy, France

DOI:

https://doi.org/10.37051/mir-00104

Keywords:

ARDS, ECMO, Mechanical Ventilation

Abstract

Veino-venous extracorporeal membrane oxygenation (VV-ECMO) allows oxygenation and decarboxylation in case of refractory acute respiratory distress syndrome. Invasive ventilation in patients under VV-ECMO aims at limiting ventilator induced lung injuries, by decreasing tidal volume, respiratory frequency and pressure levels. There is currently a lack of randomized controlled studies evaluating invasive ventilation strategies under VV-ECMO.  The ventilatory strategy during VV-ECMO is based on a "ultra-protective" ventilation, guided by the experience of each ECMO center. In its recommendations published in 2020, the Extracorporeal Life Support Organization proposes an initial ventilator setting in a pressure mode with a PEEP of 15 cmH2O, an inspiratory pressure of 25 cmH2O and a respiratory frequency of 5 cycles per minute. The intensity of ventilation can be increased to optimize gas exchange in case of persistent hypoxemia under VV-ECMO, or decreased in order to be more protective. The objective of this article is to review frequently asked questions regarding invasive mechanical ventilation during the run of VV-ECMO.

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Published

2022-06-24

How to Cite

Pequignot, B., Valentin, S., Lévy, B., Kimmoun, A., & Koszutski, M. (2022). Ventilator settings during veno-venous ECMO in ARDS patients. Médecine Intensive Réanimation. https://doi.org/10.37051/mir-00104

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