27, 53, 49
Review of management strategies for adults on extracorporeal life support, covering ventilator management, analgesia and sedation, infection and anticoagulation.
Used in Chapter 27 only for its statement of the determinants of gas transfer, which is the most compact in the sources reaching this book:
- Extracorporeal blood flow, the sweep gas oxygen fraction and the diffusion properties of the membrane are the key determinants of oxygen delivery through the circuit.
- Recirculation — reinfused oxygenated blood withdrawn back into the circuit without passing through the systemic circulation — is a source of inefficiency and may be a reason for inadequate systemic oxygenation.
- The major determinants of carbon dioxide removal are sweep gas flow and the arterial carbon dioxide tension that creates the diffusion gradient, with extracorporeal blood flow playing a lesser role — EXCEPT at the low end of the blood flow range, where it becomes a major determinant.
The final clause is the one Chapter 27 leans on, because it is the textual anchor for the boundary condition that the 12-pig experiment (Qian 2024) then demonstrates empirically: the independence of the two knobs holds at full ECMO flows and breaks down at carbon-dioxide-removal flows.
Its ventilator and sedation material is owed to Chapter 53 and Chapter 49 and is not used here.
Read as indexed full-text passages. DOI not independently resolved.