2025 Multiprofessional Critical Care Review: Adult Online-How to use VV ECMO

Video Transcription

Video Summary

Kate Nugent's lecture provides an overview of venovenous extracorporeal membrane oxygenation (VV ECMO) focusing on its relationship to the cardiopulmonary system, indications, physiology, troubleshooting, and management. VV ECMO is indicated for potentially reversible refractory hypoxia and hypercarbia after optimized medical management, with contraindications including prolonged mechanical ventilation over 7 days, severe comorbidities, and certain immunosuppressions. Oxygenation depends primarily on ECMO circuit blood flow, while CO2 removal relates to sweep gas flow. VV ECMO does not directly affect hemodynamics; cardiac output remains native. Troubleshooting refractory hypoxia involves addressing oxygen delivery-consumption imbalances via increasing hemoglobin, ECMO flow, adding cannulas, sedation, or beta blockers. Recirculation, where oxygenated blood loops back into the circuit without systemic delivery, is a critical cause of worsening hypoxia despite increasing flow. Weaning is based on improved native lung function and gas exchange, with gradual reduction of ECMO flows and sweep gas. Complications include bleeding, hemolysis, limb ischemia, and equipment failure.

Meta Tag

Concept Venovenous ECMO

Concept Oxygenation

Concept Carbon Dioxide Removal

Concept Recirculation

Concept Acute Hypoxemic Respiratory Failure

Keywords

venovenous extracorporeal membrane oxygenation

VV ECMO

refractory hypoxia

ECMO circuit blood flow

recirculation

ECMO complications

Venovenous ECMO

Oxygenation

Carbon Dioxide Removal

Recirculation

Acute Hypoxemic Respiratory Failure

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