ECMO Weaning and Decannulation
As pulmonary function recovers in ARDS patients on ECMO, pulmonary mechanics and gas exchange improve. Depending on the mode of extracorporeal support (venovenous versus venoarterial), oxygenator sweep gas flow or ECMO pump blood flow is slowly weaned. Once stability at low levels of support is established, patients are trialed-off from ECMO for 1–2 h to prove that cardiopulmonary function can be maintained at reasonable levels of support by conventional methods. ECMO support is then terminated and the cannulae are removed. Unfortunately, in some other patients, further therapy might be deemed to be futile, and therapy would have to be terminated. Goals for ECMO weaning and decannulation should ideally be set before extracorporeal support is initiated.
KeywordsAcute respiratory distress syndrome Extracorporeal life support Extracorporeal membrane oxygenation Weaning Trialing-off Decannulation Liberation Termination
Dr Krishnan has no conflicts to disclose.
Dr Schmidt has no conflicts to disclose.
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