Description

Extracorporeal Membrane Oxygenation (ECMO) is not intended for everyone. It should not be offered to a pediatric patient with absolute contraindications and may be of limited benefit to a patient with relative contraindications.


 

Absolute contraindications:

(1) coagulopathy that would be uncontrollable if receiving heparin

(2) cardiac and/or respiratory failure AND >= 2 other major organ system failures

(3) cardiac failure expected to last at least 10-14 days

(4) respiratory failure expected to last at least 10-14 days

(5) underlying condition that is life-threatening or which is expected to be terminal in a short period of time

(6) end-stage HIV disease

(7) severe and irreversible brain damage

(8) irreversible elevated pulmonary vascular resistance

 

Relative contraindications:

(1) HIV disease

(2) septic shock

(3) significant immunosuppression

(4) recent CNS hemorrhage

(5) severe gastrointestinal hemorrhage

(6) need for prolonged CPR prior to starting ECMO

(7) severe renal disease with serum creatinine > 3.0 mg/dL

(8) recent trauma

(9) recent major surgery

(10) profound shock refractory to medical management

(11) mechanical ventilation for >= 10 days

(12) underlying disease with high mortality rate

 

where:

• With HAART HIV disease has become more of a chronic disease. People with well-controlled disease may have near-normal survivals.

 


To read more or access our algorithms and calculators, please log in or register.