Extracorporeal life support

• Cannulation
  • VV provides respiratory support but no circulatory support
  • VA provides both respiratory and circulatory support
• Extracorporeal circuit
  • Blood flow: start with 50-80 mL/kg/min, titrating to lowest flow to maintain SaO₂ >80-85% at rest vent settings
  • Oxygenation: usually targets SaO2 80-85%
  • Sweep flow: typically 1:1 gas:blood; increased flow will increase CO₂ clearance without affecting oxygenation
    • e.g. for purely hypercapneic respiratory failure, blood flow can be very low (0.5 L/min/m²) while sweep flow is high (10:1)
    • Titrate to maintain PaCO₂ at 40 mmHg
  • Sweep gas: typically 95 to 100% FiO₂