{"id":1385,"date":"2026-03-15T09:44:21","date_gmt":"2026-03-15T09:44:21","guid":{"rendered":"https:\/\/perfusfind.com\/ic\/?p=1385"},"modified":"2026-03-15T09:44:21","modified_gmt":"2026-03-15T09:44:21","slug":"physiological-and-clinical-effects-of-two-ultraprotective-ventilation-strategies-in-patients-with-vv-ecmo-the-ecmovent-study","status":"publish","type":"post","link":"https:\/\/perfusfind.com\/ic\/index.php\/2026\/03\/15\/physiological-and-clinical-effects-of-two-ultraprotective-ventilation-strategies-in-patients-with-vv-ecmo-the-ecmovent-study\/","title":{"rendered":"Physiological and clinical effects of two ultraprotective ventilation strategies in patients with VV-ECMO: the ECMOVENT study"},"content":{"rendered":"<blockquote id=\"ember62\" class=\"ember-view reader-text-block__blockquote\"><p>ECMOVENT: Comparing Two Ultraprotective Ventilation Strategies on VV-ECMO<\/p><\/blockquote>\n<p id=\"ember63\" class=\"ember-view reader-text-block__paragraph\"><strong>Abstract:<\/strong> The optimal ventilatory strategy for ARDS patients on VV-ECMO remains debated. This single-center, before-and-after study compared two <strong>ultraprotective approaches<\/strong>:<\/p>\n<ul>\n<li><strong>VT1 strategy<\/strong>: Assist-controlled volume mode, VT 1 ml\/kg PBW, RR 5\/min, Pplat 20\u201325 cmH\u2082O.<\/li>\n<li><strong>\u0394P8 strategy<\/strong>: Pressure-controlled mode, \u0394P 8 cmH\u2082O, PEEP 14 cmH\u2082O, RR 10\/min.<\/li>\n<\/ul>\n<p id=\"ember65\" class=\"ember-view reader-text-block__paragraph\">Among <strong>121 patients (2016\u20132023)<\/strong>, the \u0394P8 group had <strong>lower PaCO\u2082, higher \u0394P and mechanical power<\/strong>, but <strong>similar survival and ECMO-weaning rates<\/strong> at 90 days.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember66\" class=\"ember-view reader-text-block__heading-3\">Key Insights<\/h3>\n<ol>\n<li><strong>Cohort:<\/strong> 121 severe ARDS patients, 69 with VT1 (pre-2021), 52 with \u0394P8 (post-2021).<\/li>\n<li><strong>Respiratory mechanics:<\/strong> Both strategies reduced VT, RR, \u0394P, and plateau pressures after ECMO initiation.<\/li>\n<li><strong>\u0394P8 effects:<\/strong> Lower PaCO\u2082, higher \u0394P and RR, more static elastic mechanical power, less prone positioning, and lower ECMO pump flows.<\/li>\n<li><strong>Outcomes:<\/strong> Survival 30% (VT1) vs 42% (\u0394P8, p=0.19). No significant difference in ECMO-weaning time or day-90 mortality.<\/li>\n<li><strong>CT sub-study:<\/strong> Both strategies showed massive aeration loss and similar recruitment potential; no clear advantage.<\/li>\n<\/ol>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember68\" class=\"ember-view reader-text-block__heading-3\">Why This Matters<\/h3>\n<p id=\"ember69\" class=\"ember-view reader-text-block__paragraph\">Ultra-protective strategies remain essential to limit VILI during ECMO. This study suggests \u0394P8 improves decarboxylation but <strong>does not translate into better survival or ECMO liberation<\/strong> compared with quasi-apneic VT1.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember70\" class=\"ember-view reader-text-block__heading-3\">Conclusion<\/h3>\n<p id=\"ember71\" class=\"ember-view reader-text-block__paragraph\">Both <strong>VT1 and \u0394P8 strategies effectively reduce VILI determinants<\/strong> during ECMO. Physiological differences did not yield improved clinical outcomes, underlining the need for <strong>prospective multicenter trials<\/strong>.<\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<h3 id=\"ember72\" class=\"ember-view reader-text-block__heading-3\">Take-Home for Clinicians<\/h3>\n<ul>\n<li>Either <strong>VT1 or \u0394P8<\/strong> can be safely applied in VV-ECMO ARDS.<\/li>\n<li><strong>\u0394P8 improves CO\u2082 clearance<\/strong> but increases driving pressure and mechanical power.<\/li>\n<li>Survival benefit remains unproven\u2014ventilation should be <strong>tailored to patient physiology<\/strong>.<\/li>\n<\/ul>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<p id=\"ember74\" class=\"ember-view reader-text-block__paragraph\"><strong>Discussion Question:<\/strong> Should ECMO ventilatory strategies focus on <strong>PaCO\u2082 control<\/strong> or strictly on minimizing mechanical power?<\/p>\n<p><strong><a class=\"article-editor-link article-editor-link\" style=\"font-size: 16px; background-color: #ffffff;\" href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2110582025001128?via%3Dihub\" rel=\"noopener noreferrer\">ACCESS FULL ARTICLE HERE<\/a><\/strong><\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-medium wp-image-1393\" src=\"https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756420180822-300x300.png\" alt=\"\" width=\"300\" height=\"300\" srcset=\"https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756420180822-300x300.png 300w, https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756420180822-150x150.png 150w, https:\/\/perfusfind.com\/ic\/wp-content\/uploads\/2026\/03\/1756420180822.png 490w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h3 id=\"ember77\" class=\"ember-view reader-text-block__heading-3\">Take Advantage of This Resource<\/h3>\n<p id=\"ember78\" class=\"ember-view reader-text-block__paragraph\">I encourage you to explore this growing <strong>library of articles<\/strong> and leverage it to stay informed on the latest in critical care. Visit the collection today at: <a class=\"aAIDarVlJjjXEMUykBwFgJhXtzETCscLwRim \" tabindex=\"0\" href=\"https:\/\/perfusfind.com\/ic\/\" target=\"_self\" data-test-app-aware-link=\"\"><strong>https:\/\/perfusfind.com\/ic\/<\/strong><\/a><\/p>\n<p id=\"ember79\" class=\"ember-view reader-text-block__paragraph\">This is another step in making high-quality, evidence-based information easily accessible to the critical care community. As always, thank you for your continued support!<\/p>\n<p id=\"ember80\" class=\"ember-view reader-text-block__paragraph\"><em>As always, don\u2019t forget to like, share, and subscribe. See you on the other side!<\/em><\/p>\n<hr class=\"reader-divider-block__horizontal-rule\" \/>\n<p id=\"ember81\" class=\"ember-view reader-text-block__paragraph\"><strong>Open Access<\/strong> This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article&#8217;s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article&#8217;s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit <a class=\"aAIDarVlJjjXEMUykBwFgJhXtzETCscLwRim \" tabindex=\"0\" href=\"http:\/\/creativecommons.org\/licenses\/by\/4.0\/\" target=\"_self\" data-test-app-aware-link=\"\"><strong>http:\/\/creativecommons.org\/licenses\/by\/4.0\/<\/strong><\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECMOVENT: Comparing Two Ultraprotective Ventilation Strategies on VV-ECMO Abstract: The optimal ventilatory strategy for ARDS patients on VV-ECMO remains debated. This single-center, before-and-after study compared two ultraprotective approaches: VT1 strategy: Assist-controlled volume mode, VT 1 ml\/kg PBW, RR 5\/min, Pplat 20\u201325 cmH\u2082O. \u0394P8 strategy: Pressure-controlled mode, \u0394P 8 cmH\u2082O, PEEP 14 cmH\u2082O, RR 10\/min. Among [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1392,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[3,4],"tags":[41,16,522,523,101],"class_list":["post-1385","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-circulatory","category-respiratory","tag-ards","tag-ecmo","tag-ecmovent","tag-ultraprotective-ventilation","tag-vv-ecmo"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Physiological and clinical effects of two ultraprotective ventilation strategies in patients with VV-ECMO: the ECMOVENT study - Perfusfind Intensive Care<\/title>\n<meta name=\"description\" content=\"The optimal ventilatory strategy for ARDS patients on VV-ECMO remains debated. 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