Mechanical Ventilation Management during Extracorporeal Membrane Oxygenation for Acute Respiratory Distress Syndrome. An International Multicenter Prospective Cohort

Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases

“…Once the patient is safely administered ECMO, it is important to ensure that an ultra-protective mechanical ventilation strategy is used. 11,35,36 There is no consensus on the most appropriate ventilatory strategy for ECMO. Two randomised trials of ventilation during ECMO for patients with ARDS (EOLIA; 11 plateau pressure of ≤24 cm H 2 O while applying a positive end-expiratory pressure of at Panel: Key components in the planning and provision of ECMO during an outbreak of an emerging infectious disease ECMO resource planning and allocation Embed ECMO response into the broad epidemic response strategy; identify and engage all key stakeholders; maintain a log of multidisciplinary team members specifically trained in the care of patients receiving ECMO; maintain a contemporaneous log of ECMO machines serviced and ready to deploy; ensure supply of disposables and develop a regional tracking mechanism; prepare for surge of patients…”

Ventilatory and Pharmacotherapeutic Strategies for Management of Adult Patients on Extracorporeal Life Support

“…Because ECLS can directly control carbon dioxide levels, ECLS can facilitate reductions in volumes and pressures beyond traditional lung-protective ventilation targets, often referred to as ultra-lungprotective ventilation, a general strategy that has been adopted at many ECLS centers. 16 A version of this strategy was used in the EOLIA trial, with a plateau airway pressure limit of 24 cm H 2 O for those receiving ECLS, and likely contributed to the favorable outcomes in that group. 2 Although minimization of tidal volumes, airway pressures, and respiratory rates appears to be of benefit, [17][18][19] the optimal ventilatory strategy during ECLS has yet to be defined and remains an area of active investigation.…”

Management of Extracorporeal Membrane Oxygenation for Obstetric Patients: Concerns for Critical Care Nurses

“…mechanical ventilation. 14,15 Marhong et al 15 analyzed 141 individual responses from 283 centers across 28 countries, and only 27% of these centers reported the use of explicit, mechanical ventilation protocols for ECMO patients. Most of the centers (77%) reported that lung rest was the primary goal of mechanical ventilation; 9% of the centers reported that lung recruitment was the ventilation strategy.…”