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.

Keywords

venovenous extracorporeal membrane oxygenation

VV ECMO

refractory hypoxia

ECMO circuit blood flow

recirculation

ECMO complications

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.