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Mechanical Ventilation during ECMO: Best Practices
Kyle J Rehder1, Omar S Alibrahim2
1Division of Pediatric Critical Care, Duke Children's Hospital, Durham, North Carolina. kyle.rehder@duke.edu.
Respiratory Care
|May 24, 2023
Summary
Optimizing ventilator settings during extracorporeal membrane oxygenation (ECMO) is crucial for preventing lung injury in respiratory failure patients. This guide focuses on lung-protective strategies for ECMO ventilator management.
Area of Science:
- Critical Care Medicine
- Pulmonology
- Pediatric Critical Care
Background:
- Extracorporeal membrane oxygenation (ECMO) is a life support measure for severe respiratory failure.
- Patients on ECMO remain susceptible to ventilator-induced lung injury (VILI).
- Optimized ventilator management is essential for mitigating VILI during ECMO.
Approach:
- This review synthesizes current data and guidelines on ECMO ventilator management.
- It provides a practical guide for bedside clinicians.
- Focus is placed on lung-protective ventilation strategies.
Key Points:
- Ventilator titration requires careful consideration of lung mechanics and oxygenation.
- Non-conventional ventilation modes may be employed during ECMO.
- Adjunct therapies can support lung protection in conjunction with mechanical ventilation.
Conclusions:
- Effective ventilator management is paramount for improving outcomes in ECMO patients.
- Implementing lung-protective strategies can reduce ongoing lung injury.
- This review serves as a resource for clinicians managing ECMO patients.
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