Oxygenation failure can be identified visually by a lack of colour differential and more formally by pre- and post-oxygenator gases.
Lack of oxygen delivery via the ECMO circuit regardless of the mode (VA or VV) is likely to lead to rapid patient deterioration, failure to clear CO2 may be more subtle and is usually recognised by increasing pCO2.
- Oxygen supply failure
- Oxygenator failure (thrombosis or failure over time)
Oxygen supply failure
This is a common cause and can rapidly be rectified. Common scenarios include: green oxygen tubing is kinked or disconnected (caution during transport), the oxygen cylinder has run out; the blender FiO2 has unintendedly been reduced – checking the oxygen flow at the connection to the oxygenator is considered most reliable to eliminate this.
Oxygenator thrombosis can have various characteristics but obvious forms are best identified from the inflow surface of the oxygenator. However oxygenator d