Indication for VV ECMO
One or more of the following:
- Hypoxemic respiratory failure (PaO2/FiO2 < 80 mm Hg)*, after optimal medical management, including, in the absence of contraindications, a trial of prone positioning.
- Hypercapnic respiratory failure (pH < 7.25), despite optimal conventional mechanical ventilation (respiratory rate 35 bpm and plateau pressure [Pplat] ≤ 30 cm H2O).
- Ventilatory support as a bridge to lung transplantation or primary graft dysfunction following lung transplant.
Specific clinical conditions:
- Acute respiratory distress syndrome (e.g., viral/bacterial pneumonia and aspiration)
- Acute eosinophilic pneumonia
- Diffuse alveolar hemorrhage or pulmonary hemorrhage
- Severe asthma
- Thoracic trauma (e.g., traumatic lung injury and severe pulmonary contusion)
- Severe inhalational injury
- Large bronchopleural fistula
- Peri-lung transplant (e.g., primary lung graft dysfunction and bridge to transplant) Relative contraindications for venovenous extracorporeal membrane oxygenation
- Significant central nervous system injury
- Irreversible and incapacitating central nervous system pathology
- Systemic bleeding
General Contraindications
- Irreversible injury/disease process without potential for recovery
- Malignancies
- Major immunosuppression
- Irrecoverable other end-organ failure and/or not a candidate for transplant
Consult ECMO:
- Order Surgical consult: indication ECMO
- Page General surgery
Once agreement on cannulation ACTIVATE PICU ECMO