How I Manage Drainage Insufficiency on Extracorporeal Membrane Oxygenation

Crit Care. 2020 Apr 15;24(1):151

We propose a physiology-based algorithmic approach to the management of drainage insufficiency.

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While extracorporeal membrane oxygenation (ECMO) case volume continues to increase, management of patients receiving ECMO remains technically challenging. Iatrogenic injury is a potential contributor to complications and poor outcomes. Drainage insufficiency, wherein limited pump preload leads to reduced circuit blood flow, is ubiquitous, yet there is no consensus regarding treatment. We propose a physiology-based algorithmic approach to the management of drainage insufficiency.