Which factor is NOT directly related to ECMO oxygenation management?

The factor that is not directly related to ECMO oxygenation management is the increasing patient respiratory rate. In the context of ECMO, the primary focus is on ensuring adequate oxygenation and carbon dioxide removal via the ECMO circuit, rather than relying on the patient’s own respiratory efforts.

When a patient is on ECMO, especially veno-venous ECMO (VV ECMO), the system is essentially responsible for performing the gas exchange functions that the lungs would normally carry out. Therefore, increasing the patient's respiratory rate does not directly impact the efficiency of the ECMO circuit in providing oxygenation, as it primarily relates to the patient's ability to support their own ventilation. The ECMO machine's settings—such as blood flow rates, oxygen delivery (FDO2), and hemoglobin levels—are much more significant factors for management in this context.

Increasing FDO2 directly enhances the amount of oxygen available to the patient via the ECMO circuit. Increasing flow rates through the ECMO circuit can improve oxygen transfer and carbon dioxide removal. Additionally, higher hemoglobin levels can enhance the blood's capacity to carry oxygen, directly impacting the overall oxygen delivery to the tissues, making these options critically relevant to oxygenation management on ECMO.