Chapter 7 — Initial VV ECMO Management

Published 6 Sep 2026. Two project-library papers read IN FULL: Szuldrzynski 2024 Perfusion (ventilation) and Levy 2022 ICM (anticoagulation). Organising evidence: driving pressure in the FIRST THREE DAYS was the sole independent mortality risk factor (Serpa Neto, n=545) - the justification for the chapter. Resolves the Ch 4 proning tension by presenting the actual conflicting evidence (Papazian meta-analysis favourable RR 1.31; PRONECMO RCT neutral) and handing depth to Ch 53. DECLARED SECOND-HAND: Schmidt 2019/2015, Serpa Neto 2016, Costa 2021, Giani 2022, Papazian 2022, PRONECMO, van Minnen 2023 are quoted as reported in Szuldrzynski 2024, not from primaries - flagged in-chapter. Transcription note: the review says 'no benefit of ECMO' where it plainly means 'no benefit of prone positioning'; rendered correctly and flagged. VA-specific ventilation and oxygenation content deliberately deferred to Ch 14/53.