# ECMO

Basics: https://www.atsjournals.org/doi/full/10.34197/ats-scholar.2020-0077VO

Variables: 

1. Sweep gas flow rate: controls CO2
2. Speed of pump - ECMO Flow rate: controls O2 
3. FDo2 Of sweep gas: controls O2

Pathologic recirculation: 
Blood goes from the outflow track (in SVC) back in to IVC and into the inflow track. This leads to ineffective circulation to the body and hypoxemia. Caused when: 

1. Inflow and outflow catheters are too close
2. ECMO flow rate is too high. 

Monitor pre- and post- blood gas for

- Sweep gas flow interruption: often interruption in equipment, leads to circuit apnea.
- Membrane lung failure: gas phase or blood phase failure


What to do with the ventilator? 

- PEEP 10-14, Driving pressure 10-14. Plat <25 then. 
- Fio2 50%, RR 10

Idea: lung rest to lower VILI