International Survey on Mechanical Ventilation During Extracorporeal Membrane Oxygenation

Olivier Van Minnen, Floris E.J. Jolink, the DUTCH ECLS Study Group, Walter M. Van Den Bergh, Joep M. Droogh, Annemieke Oude Lansink-Hartgring*, Alexander P.J. Vlaar, S. Jorinde Raasveld, Dirk W. Donker, Jeannine A.J. Hermens, Alexander D. Cornet, J. Wytze Vermeijden, Bob Oude Velthuis, Judith M.D. Van Den Brule, C. V.Elzo Kraemer, Jacinta J. Maas, Jeroen Janson, Jorge Lopez Matta, Thijs S.R. Delnoij, Marcel Van De PollSakir Akin, Jesse De Metz, Bas Van Den Bogaard, Luuk Otterspoor, Erik Scholten, Ineke Van De Pol, Marijn Kuijpers, Laurien Van Koppenhagen, Dinis Dos Reis Miranda, Christiaan Meuwese, Jeroen Bunge

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)
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Abstract

The optimal ventilation strategy for patients on extracorporeal membrane oxygenation (ECMO) remains uncertain. This survey reports current mechanical ventilation strategies adopted by ECMO centers worldwide. An international, multicenter, cross-sectional survey was conducted anonymously through an internet-based tool. Participants from North America, Europe, Asia, and Oceania were recruited from the extracorporeal life support organization (ELSO) directory. Responses were received from 48 adult ECMO centers (response rate 10.6%). Half of these had dedicated ventilation protocols for ECMO support. Pressure-controlled ventilation was the preferred initial ventilation mode for both venovenous ECMO (VV-ECMO) (60%) and venoarterial ECMO (VA-ECMO) (34%). In VV-ECMO, the primary goal was lung rest (93%), with rescue therapies commonly employed, especially neuromuscular blockade (93%) and prone positioning (74%). Spontaneous ventilation was typically introduced after signs of pulmonary recovery, with few centers using it as the initial mode (7%). A quarter of centers stopped sedation within 3 days after ECMO initiation. Ventilation strategies during VA-ECMO focused less on lung-protective goals and transitioned to spontaneous ventilation earlier. Ventilation strategies during ECMO support differ considerably. Controlled ventilation is predominantly used initially to provide lung rest, often facilitated by sedation and neuromuscular blockade. Few centers apply "awake ECMO" early during ECMO support, some utilizing partial neuromuscular blockade.

Original languageEnglish
Pages (from-to)300-304
Number of pages5
JournalASAIO Journal
Volume70
Issue number4
DOIs
Publication statusPublished - 1 Apr 2024

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