Femoro-jugular cannulation in veno-venous extracorporeal membrane oxygenation PRO/CON

In this technique, the artificial lung is in series with the failing native lungs. Thus, the decarboxylated and oxygenated blood goes through the native lungs decreasing the pulmonary vascular resistances and allowing protective mechanical ventilation. The fundament of veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is to dissociate the oxygenation and the decarboxylation functions. Carbon dioxide (CO2) removal does not depend on blood flow in the ECMO circuit, conversely on the flow of the gas mixture through the membrane. By contrast, oxygenation depends on fraction of oxygen (FiO2) in the gas mixture and on ECMO flow. Oxygenation is not influenced by sweep gas flow. Therefore this system is based on a patient adequate circulation and cardiac function and it is indicated for isolated lung failure after optimization of the ventilatory support and the medical treatment (1-3)