Maryland CC Project Combes – Mechanical Ventilation on VV-ECMO
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Aug 18, 2024 Dr. Alain Combes, a leading professor of intensive care medicine from Sorbonne Université, dives into the intricacies of mechanical ventilation for patients on veno-venous ECMO. He emphasizes tailored ventilation strategies, especially for severe ARDS patients during the COVID-19 pandemic. The discussion includes critical metrics like driving pressure and the significance of individualized PEEP adjustments. Dr. Combes shares recent findings aimed at minimizing ventilator-induced lung injury and improving patient survival outcomes.
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Speaker Background And Timing
- Dr. Alain Combes opened the talk from France and explained timing differences for the audience.
- He framed himself as an ECMO researcher who would cover ventilation on venovenous ECMO.
ECMO Lowers Ventilator-Induced Lung Stress
- Dr. Alain Combes emphasized ECMO mainly reduces ventilator-induced lung injury by taking over gas exchange and lowering lung stress and strain.
- He argued ECMO's key role is to permit rapid reduction of ventilator intensity in severe ARDS.
Initiate ECMO Early When Indicated
- Do consider early VV-ECMO for refractory severe ARDS because each extra day of mechanical ventilation before ECMO raises mortality.
- Dr. Alain Combes reported an observed 7% mortality increase per additional ventilator day before ECMO.