ICU Cases · ECMO
Hot case — the bedside: the VV ECMO weaning trial
A CICM hot case — a bedside encounter on the VV ECMO weaning. Tests the sweep-off trial, the interpretation of the native-lung gas exchange, and the decannulation decision.
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CICMFFICMEDIC
Prompt
At the bedside of a patient on day 10 of VV ECMO for the severe ARDS, whose lung has been improving. Assess and perform the weaning trial.
Presentation
You are taken to the bedside of a 50-year-old man on day 10 of the VV ECMO for a severe ARDS (influenza). His lung compliance has been improving, his FiO2 on the ventilator is 0.4 with a PEEP of 10 and a tidal volume of 4 mL/kg. The team asks you to assess for the readiness to wean.[1]
References2ShowHide
- [1]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.
- [2]Marino PL The ICU Book. 4th edition, Lippincott Williams & Wilkins, 2014.