ECMO recirculation happens when there is less than 10 cm distance

• related: ECMO extracorporeal membrane oxygenation
• tags: #literature #icu

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Recirculation occurs with VV-ECMO when reinfused oxygenated blood is withdrawn through the drainage cannula without passing through the systemic circulation and therefore is not contributing to the patient’s oxygenation. A classic sign of recirculation is the presence of a low peripheral SpO2 and a high preoxygenator saturation. Factors that commonly affect recirculation include cannula configuration and positioning, pump speed, and ECMO blood flow rate. Strategies to mitigate recirculation include a trial to decrease ECMO blood flow rates and repositioning of the femoral venous drainage cannula. There is no evidence of recirculation.¹²³⁴

Links to this note

• ECMO extracorporeal membrane oxygenation
  • ECMO recirculation happens when there is less than 10 cm distance

Footnotes

1. SEEK Questionnaires ↩

2. Badulak JH. Venovenous extracorporeal membrane oxygenation. Flow, pressure, hematology, and emergencies. ATS Sch. 2020;2(1):138-139. PubMed ↩

3. Patel B, Arcaro M, Chatterjee S. Bedside troubleshooting during venovenous extracorporeal membrane oxygenation (ECMO). J Thorac Dis. 2019;11(suppl 14):S1698-S1707. PubMed ↩

4. Zakhary B, Vercaemst L, Mason P, et al. How I approach membrane lung dysfunction in patients receiving ECMO. Crit Care. 2020;24(1):671. PubMed ↩