Low Blood Arterial Oxygenation During Venovenous Extracorporeal Membrane Oxygenation: Proposal for a Rational Algorithm-Based Management

VVeno-venous extracorporeal membrane oxygenation (VV-ECMO) is an important tool in the management of most severe forms of acute respiratory failure. The determinants and management of oxygen delivery in patients treated with VV-ECMO is a complex topic. The physiological principles of oxygenation on VV-ECMO are reviewed in many textbooks. However a numerical model is an additional instrument to be used in understanding and exploring this intricate subject matter. We present a numerical model of blood oxygenation during VV-ECMO. Using this model we examined the role and impact of each determinant on blood oxygenation. The numerical analysis of variation and interplay between each oxygenation determinants during VV-ECMO is presented in graphical form. These results corroborate all the findings of previous studies. The proposed numerical model facilitates understanding of oxygenation physiology during VV-ECMO; it can be used for a medical simulation system and for teaching the principles of oxygenation during VV-ECMO.