2, 6, 7, 9
Gives a quantitative basis for interpreting arterial saturation on VV ECMO as a mixture, and for recognising that a falling venous saturation lowers arterial saturation with the circuit behaving normally.
Not applicable
DOI 10.1177/02676591241238156
Not applicable - physiological synthesis and modelling
Modelled physiological relationships, not outcome-validated targets. No clinical endpoints.
Expresses arterial and pulmonary arterial saturation as the flow-weighted average of circuit blood and blood bypassing the circuit. Practical anchor: an effective ECBF/CO ratio of about 0.6 with venous saturation 75% and a fully saturating oxygenator yields roughly 90% arterial saturation in complete native lung dysfunction; the ratio must rise as venous saturation falls. Effective rather than total circuit flow must be used when recirculation is present. Sweep gas flow is the analogue of native minute ventilation and the primary determinant of CO2 removal; CO2 removal rises logarithmically with blood flow and plateaus according to membrane surface area.
Adults on venovenous ECMO