VV-ECMO Simulator · Teaching Tool

VL/min

—

Crpm

—

P_venmmHg

—

P_intmmHg

—

P_artmmHg

—

SWEEP

—

L/min

FiO₂

—

membrane

🫁 OK 🔁 low ✔ no alarms

Cannula

Gas delivery — Oxygen blender & sweep flow

Drag the FiO₂ dial or the flow float — synced with the sliders & all calculations

👤 Patient

Gender

Height—

Weight—

Predicted body weight (PBW)

—kg

Tidal volume

—mL

VT per kg PBW (lung-protective ≤6)

—mL/kg

⚡ Mechanical Power (VILI risk)

Mechanical Power

— J/min

—

Tidal volume / kg PBW

—mL/kg

Plateau pressure

—cmH₂O

Minute ventilation

—L/min

Driving pressure

—cmH₂O

MP = 0.098 · RR · V_T · (PEEP + ½·ΔP_driving + P_resistive) — Gattinoni 2016. Targets: <17 J/min safe · 17–22 caution · >22 high VILI risk. Driving pressure <15 cmH₂O.

ECG II

Pleth

ART

CVP

RESP

EtCO₂

HR bpm

—

SpO₂ %

—

PR —

ART mmHg

—

CVP mmHg

—

RESP rpm

—

EtCO₂ mmHg

—

Pre-Oxygenator—

Post-Oxygenator—

ΔP Oxygenator—

TEMP °C

—

Oxygen delivery / consumption

DO₂ — Oxygen Delivery

—mL/min

VO₂ — Oxygen Consumption

—mL/min

DO₂ / VO₂ ratio

—

O₂ extraction (ERO₂)

—%

CaO₂ arterial content

—mL/dL

Effective ECMO flow

—L/min

Serum lactate

—mmol/L

O₂ debt (unmet VO₂)

—mL/min

Membrane ΔP · max allowed

—mmHg

Patient / blood inputs

Hemoglobin

—

Native cardiac output

—

Native lung function

—

Tissue O₂ demand

—

Temperature

—

→ Recirculation (computed)

—

🫀 Patient oxygenation

Cardiac output ÷ ECMO blood flow ratio

—

Lower ratio (more ECMO flow per CO) → higher patient SaO₂/PO₂

🧫 Membrane health (clot burden ↓ this)—

Pre-oxy O₂ sat (drainage)

—%

Post-oxy SaO₂

—%

Mixed venous SvO₂

—%

CaO₂ arterial content

—mL/dL

Effective ECMO flow

—L/min

Recirculation

—%

Pre-oxy PO₂

—mmHg

Post-oxy PO₂

—mmHg

Membrane ΔP

—mmHg

Pre-oxy PCO₂

—mmHg

Post-oxy PCO₂

—mmHg

Membrane CO₂ removal

—mmHg

🩺 Treatment

Sedation↓ VO₂💤 Analgesia↓ VO₂💉 ParalysisNMB — ↓ VO₂, stops shivering💪 Antipyretics↓ temp → ↓ VO₂🧊 Transfusion+2 u → Hgb +2 → ↑ DO₂🩸 Oxygenator swapfresh membrane → treats clot🔄 β-blocker↓ CO — ⚠ also ↓ DO₂💓 Cannula repositionwiden tips → ↓ recirc🪡 Fluid boluseuvolaemia → ↓ recirc💧

Metabolic rate factor → VO₂ demand

—

Sedation, analgesia, paralysis & antipyretics ↓ VO₂ · fever ↑ VO₂ · β-blocker ↓ CO → ↓ DO₂ (worsens DO₂:VO₂)

🌬️ Mechanical ventilator (Hamilton-C6)

PCV+ · Hamilton-C6

Pressure — Paw (cmH₂O) vs time

Flow (L/min) vs time

Volume (mL) vs time

Cstat — mL/cmH₂O PetCO₂ — mmHg SpO₂ —% PBW 66 kg

b/min

Rate

mbar

Pcontrol

mbar

PEEP

Oxygen

1.5

Insp. time

mL/cmH₂O

Compliance

cmH₂O/L/s

Resistance

Ppeak

—

cmH₂O

ExpMinVol

—

L/min

VTE

—

fTotal

—

b/min

Driving P

—

cmH₂O

Compliance & Resistance are patient lung properties — they change Ppeak, the flow/volume curves and Mechanical Power.

📚 Teaching Module

Gas delivery — Oxygen blender & sweep flow

👤 Patient

⚡ Mechanical Power (VILI risk)

Oxygen delivery / consumption

🌬️ Mechanical ventilator (Hamilton-C6)

Select a scenario