Low Flow Veno-Venous ECMO: An Experimental Study

Clinical use of extracorporeal membrane oxygenation (ECMO) and carbon dioxide removal (ECCO2R) have become well established techniques for the treatment of severe respiratory failure; however they require full cardiopulmonary bypass, representing major procedures with high morbidity. We theorized the possibility of an efficient low flow venavenous extracorporeal membrane gas exchange method. Four mongrel 12kg dogs were submitted to vena-venous extracorporeal membrane gas exchange via a jugular dialysis catheter using a low flow (10 ml/min) roller pump and a membrane oxygenator for a period of four hours. Respiratory rate was set at 4 breaths/min with a FiO2 of 21% and ventilatory dead space was increased. Adequate gas exchange was obtained (pO2 139, pCO2 24, Sat 99.4%), without major hemodynamic changes or hematuria. Our results demonstrate the feasibility of a low flow, less aggressive system. Further research should be considered