VV ECMO

 

Indication for VV ECMO

 

One or more of the following:

  1. Hypoxemic respiratory failure (PaO2/FiO2 < 80 mm Hg)*, after optimal medical management, including, in the absence of contraindications, a trial of prone positioning.
     
  2. Hypercapnic respiratory failure (pH < 7.25), despite optimal conventional mechanical ventilation (respiratory rate 35 bpm and plateau pressure [Pplat] ≤ 30 cm H2O).
     
  3. 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
  • Central nervous system hemorrhage
  • Significant central nervous system injury
  • Irreversible and incapacitating central nervous system pathology
  • Systemic bleeding
  • Contraindications to anticoagulation
  • Immunosuppression
  • Older age (increasing risk of death with increasing age, but no threshold is established)
  • Mechanical ventilation for more than 7 days with Pplat > 30 cm H2O and FiO2 > 90%

Who to alert when patient meets criteria at UMMC:


Enter an EPIC order for ECMO IP Consult indicating need for VV consult

OR

Page the ECMO RESPIRATORY FAILURE provider

If outside UMMC calling refer them to:


612-273-ECMO (612-273-3266)