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. Author manuscript; available in PMC: 2022 Jun 1.
Published in final edited form as: ASAIO J. 2021 Jun 1;67(6):601–610. doi: 10.1097/MAT.0000000000001432

Table 3:

Recommended Mechanical Ventilation Settings During Adult VV ECMO

Parameter Acceptable Range Recommendation Comments
Inspiratory plateau pressure (Pplat) ≤ 30 cmH2O < 25 cmH2O Further reductions in Pplat below 20 cmH2O may be associated with less VILI and improved patient outcomes24–26
PEEP 10–24 cmH2O ≥ 10 cmH2O Reductions in Pplat and tidal volume may lead to atelectasis without sufficient PEEP; PEEP can be set according to various evidence-based methods (e.g., ARDSNet PEEP-FiO2 table or Express trial strategy) while maintaining the Pplat limit27
Respiratory rate (RR) 4–30 breaths/min 4–15 breaths/min (set RR) or spontaneous breathing CO2 elimination is being provided primarily by VV ECMO, reducing the need for high minute ventilation (which may be associated with more VILI)
FiO2 30–50% As low as possible to maintain saturations Oxygenation is being provided primarily by VV ECMO, reducing the need for high FiO2 from the ventilator unless required to maintain adequate oxygenation