Oxygen delivery and carbon dioxide removal on venovenous extracorporeal membrane oxygenation

This review aims to provide insights into the evolving role of VV-ECMO in the management of critical respiratory failure. Key determinants of oxygenation are discussed, particularly optimizing the ratio of VV-ECMO blood flow to cardiac output (CO). We analyze factors influencing CO 2 clearance and review available VV-ECMO configurations and their effects on gas exchange. We discuss practical targets for oxygenation and CO 2 removal in VV-ECMO, along with adjunctive techniques for refractory hypoxemia and hypercapnia.