What percentage of cardiac output is provided by VV ECMO?

VA ECMO can provide 60% to 80% of predicted resting cardiac output. 7 Targeted flow rates in adults are generally 60 to 80 mL/kg/min.

How do you calculate recirculation in VV ECMO?

Percent recirculation is quantified by the following equation: Recirculation (%) = (SpreO2 – SvO2)/(SpostO2 – SvO2) x100; However, SvO2 is difficult to measure because of the presence of reinfused oxygenated blood. Several methods have been used to quantify the amount of recirculation (Table 1).

What is flow rate on ECMO?

Typical ECMO flow rates for an adult are between 60 and 80 mL/kg/min (4 to 6 L/min) and are gradually reduced to less than 30% of that total for weaning [4].

How do you calculate ECMO cardiac output?

Cardiac output can be calculated by using the following oxygen delivery equation: Total O2 delivery = ECMO oxygen delivery + ventricular oxygen delivery.

What are ECMO settings?

Check ECMO blood flow: initial settings include keeping ECMO blood flow at a minimum of 60% of the cardiac output in order to reduce the fraction of non-oxygenated venous blood flow that will mix with oxygenated blood.

What is sweep gas in ECMO?

Sweep gas flow rate The rate of sweep gas flow through the membrane lung determines blood decarboxylation. Carbon dioxide tension (pCO2) is mostly unaffected by FDO2 or ECMO blood flow once it is adequate.

What does VV ECMO mean?

V-V ECMO. V-V or veno-venous ECMO, supports lung function primarily. The surgeon will place the cannulae in a large vein only, usually in the neck. Based on the patient’s age and condition, the surgeon may choose to place one special cannula in a single vein or place two cannulae in two different veins.

What are the parameters of ECMO?

The parameters are the rotations per minute (RPM) and the blood flow. The therapeutical goal set by the team is the blood flow. For the nurse, writing down these two parameters has no relevance. The correlation of the RPM and blood flow and its evolution through time will allow an effective management of the ECMO run.

What is a VV ECMO machine?

The VV ECMO machine is connected to one or more veins, usually near the heart, and is used to support only the lungs. Based on the patient’s age and condition, the cardiothoracic surgeon may choose to place one special cannula in a single vein that is close to or inside the heart or two cannulae in different veins.

How is O2 determined during V-V ECMO?

However, the following general principles apply: During V-V ECMO, arterial O2 is primarily determined by the relationship between the ECMO pump flow and the patient’s cardiac output.

How much cardiac output is required for 90% saturation on ECMO?

A flow rate of approximately 66% of cardiac output is necessary to achieve patient saturation of > 90%. For patients on V-V ECMO it is common for the maximum achievable arterial PO2 to only be in the range 55-90 mmHg. Removal of CO2 by the ECMO circuit is very efficient and is proportional to the “sweep” gas flow through the oxygenator.