8 in 8 Critical Care Series: Hypoxemia During Veno-Venous ECMO

Hypoxemia during veno-venous (VV) extracorporeal membrane oxygenation (ECMO) mandates recognition and therapeutic management. This STS 8 in 8 video identifies the basis of hypoxemia during VV-ECMO support, such as cannula recirculation and shunted blood. Viewers will also learn remediation management strategies.
Presenters:
Cory M. Alwardt, PhD, CCP
Mayo Clinic Arizona
Rita K. Milewski, MD, PhD, MSEd
Yale University
STS invites viewers to provide feedback and ask questions. Email [e-mail].
Please note: No CME credit is associated with the viewing of web-based content. STS retains sole rights to these materials.

[@peterfslife]

So I'm using an ECMO simulator to simulate ECMO. This simulator has been worked on for MANY yeas. I can set several parameters, like Pulmonary Shunt, Dead Space, and Lung Compliance. I want to simulate a patient who's lungs are completely unusable, and the VV ECMO support is DOING ALL of the oxygenation, and ventilation. I've got my Shunt set at 100%, and I have the lung compliance so low that with Pressure Control, I'm at most able to get SAFELY 20 ml Tidal Volume. I want to simulate COMPLETE respiratory failure. THAT ECMO support is doing EVERYTHING as far as oxygenation, and ventilation. Can I set the dead space higher than the tidal volume I'm getting on my ventilator? Is that accurate?