The effects of mechanical ventilation during v-a ecmo support: a systematic review
Authors' conclusion
Evidence on the effects of mechanical ventilation during V-A ECMO on cardiac function, recovery and clinical outcomes is limited, heterogeneous, and at considerable risk of bias.
Study context
- Population
- Adults supported by V-A ECMO or animal V-A ECMO models12 studies
- Comparison
- Mechanical ventilation settings and adjunctive respiratory interventions during V-A ECMO
Methodological detailsno pooling of results, 5,750 records screened; 10 clinical, 1 experimental, 1 computational studies included
- No pooling of results
- 5,750 records screened; 10 clinical, 1 experimental, 1 computational studies included
Pooled result
As reported in the abstract
- Lower driving and peak inspiratory pressures and reduced respiratory rates associated with improved survival (4 human studies)
- Moderate positive end-expiratory pressure (PEEP) lung-protective without compromising cardiac function; excessive PEEP impaired systolic function without systemic hypotension (1 study)
- Higher intrathoracic pressures may be cardioprotective by unloading the left ventricle and reducing myocardial oxygen demand (computational study)
- Very limited studies of adjunctive strategies (inhaled nitric oxide, oxygenation targets), at least moderate risk of bias
Original publication
The effects of mechanical ventilation during v-a ecmo support: a systematic review. Crit Care. Published 5 June 2026. doi:10.
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