Weaning and Decannulation of Neonatal and Pediatric Respiratory ECMO Support

The intention of extracorporeal membrane oxygenation (ECMO) support in children with respiratory failure is to rest the lungs, give them time to heal, and prevent further lung injury while ensuring adequate oxygen delivery to the entire body. This chapter reviews the available evidence for lung-protective ventilation on ECMO, how to monitor recovery of lung function, and when and how to wean the patient off extracorporeal life support. Achieving adequate weaning from ECMO depends fully on the recovery of the lungs. It is essential that when ECMO is initiated in children with respiratory failure every attempt is made to rest the lungs, prevent secondary injury and give enough time to heal.