Indications
Guidelines that describe the indications and practice of ECMO are published by the Extracorporeal Life Support Organization (ELSO). Criteria for the initiation of ECMO include acute severe cardiac or pulmonary failure that is potentially reversible and unresponsive to conventional management. Examples of clinical situations that may prompt the initiation of ECMO include the following:
- Hypoxemic respiratory failure with a ratio of arterial oxygen tension to fraction of inspired oxygen (PaO2/FiO2) of <100 mmHg despite optimization of the ventilator settings, including the tidal volume, positive end-expiratory pressure (PEEP), and inspiratory to expiratory (I:E) ratio
- Hypercapnic respiratory failure with an arterial pH <7.20
- Refractory cardiogenic shock
- Cardiac arrest
- Failure to wean from cardiopulmonary bypass after cardiac surgery
- As a bridge to either cardiac transplantation or placement of a ventricular assist device
Read more about this topic: Extracorporeal Membrane Oxygenation
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