Ultra-Low Tidal Volume Mechanical Ventilation in ARDS Through ECMO

Exclusion Criteria

• •1. Currently receiving any form of ECMO (e.g., venovenous, venoarterial, or hybrid configuration)
• •2. Chronic hypercapnic respiratory failure defined as PaCO2 \> 60 mmHg in the outpatient setting
• •3. Home mechanical ventilation (non-invasive ventilation or via tracheotomy), not CPAP
• •4. Actual body weight exceeding 1 kg per centimeter of height
• •5. Severe hypoxemia with PaO2/FiO2 \< 80 mmHg
• •6. Expected mechanical ventilation duration \< 48 hours
• •7. Treating team is in the process of moving to a palliative mode of care
• •8. Moribund patient not expected to survive 24 hours despite ongoing life-sustaining therapies
• •9. Confirmed diffuse alveolar hemorrhage from vasculitis
• •10. Contraindications to limited anticoagulation (e.g., active GI bleeding, bleeding diathesis)
• •11. Pregnancy - due to unknown effects of PaCO2 changes on placental blood flow