ECMO recirculation happens when there is less than 10 cm distance

Recirculation occurs with VV-ECMO when reinfused oxygenated blood is withdrawn through the drainage cannula without passing through the systemic circulation and therefore is not contributing to the patient’s oxygenation.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, repositioning of the femoral venous drainage cannula, or conversion of a dual-cannula configuration to a single-cannula configuration where recirculation is less commonly observed. 12345

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 ↩

  5. Abrams D, Bacchetta M, Brodie D. Recirculation in venovenous extracorporeal membrane oxygenation. ASAIO J. 2015;61(2):115-121. PubMed ↩