Ventilation on ECMO

Description

Ventilation on ECMO focuses on lung-protective strategies while extracorporeal support maintains gas exchange. Typically, “ultra-protective” ventilation is used with low tidal volumes (4 mL/kg), low plateau pressures (<25 cmH₂O), and moderate to high PEEP to prevent atelectasis. Driving pressures are minimized, and FiO₂ is kept low to reduce oxygen toxicity. Modes like pressure control or APRV may be employed. ECMO allows the lungs to “rest,” minimizing ventilator-induced lung injury while optimizing oxygenation and CO₂ clearance until pulmonary recovery occurs.