Bedside troubleshooting during venovenous extracorporeal membrane oxygenation (ECMO)

Mortality from severe respiratory failure and acute respiratory distress syndrome (ARDS) ranges from 40% to 50% with conventional medical management (1). Venovenous (VV) extracorporeal membrane oxygenation (ECMO) is evolving as a treatment option for managing severe respiratory failure that is refractory to conventional therapies. The use of ECMO continues to expand as monitoring and management methods improve. ECMO has been used successfully as a bridge to lung transplant, for primary graft dysfunction after lung transplantation, during or after high-risk thoracic operations, and for treating massive pulmonary hemorrhage and trauma (2-4). The primary goal of VV-ECMO is to manage hypoxemia and hypercarbia due to respiratory failure, so as to allow lung rest and promote subsequent recovery