Mechanical Ventilation during Extracorporeal Membrane Oxygenation in Patients with Acute Severe Respiratory Failure

Figure 1

Management of severe acute respiratory distress syndrome in adults. Note that extracorporeal membrane oxygenation is provided after failure of conventional ventilation. Step  1 is the use of conventional MV for ARDS patients. Protective ventilation is typically employed. If the patient responds poorly to the initial MV setting, the strategy is to initiate VV-ECMO with the therapeutic target to maintain SaO₂ and serum pH. Weaning off the ECMO is considered when the blood and gas flow are decreased to 2 L/min and 21%, respectively. The figure was adapted from [9] under the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. MV: mechanical ventilation; VV-ECMO: venovenous extracorporeal membrane oxygenation; MAP: mean arterial pressure; PEEP: positive end-expiratory pressure; RR: respiratory rate.