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Table 1 Criteria for the use of extracorporeal membrane oxygenation (ECMO).

From: Factors associated with outcomes of patients on extracorporeal membrane oxygenation support: a 5-year cohort study

Type of organ failure Criteria
Respiratory failure 1- Treatable underlying respiratory condition
2- Absence of contraindications
Severe chronic liver disease
Severe brain injury
Non-responsive malignancy
3- Requirements for unsafe ventilation to achieve SaO2 > 88% or pH > 7.20
Plateau pressure > 35 cmH 2 O
Tidal volume > 6 ml/Kg predicted body weight (PBW)
4- With hypoxaemia (SaO2 < 88%) despite
FiO2 ≥ 90%
Trial of high positive end-expiratory pressure (between 18 and 22 cmH 2 O)
Trial of recruitment manoeuvre (if not contraindicated)
2-12 hour trial of inhaled nitric oxide (NO) if available
Adequate cardiac support (echocardiography assessment, inotropes, pulmonary vasodilators)
5- Or requirement for inter-hospital transport
6- Rate of lung injury progression*
Cardiac failure 1. Diagnosis of cardiogenic shock:
Echocardiography examination to confirm the presence and nature of cardiac dysfunction and exclude correctible problems
2. Cardiac index and blood pressure inadequate for organ support despite
Moderate- or high-dose inotropes (adrenaline > 0.3 μg/Kg/min equivalent) in combination with an intra-aortic balloon pump (IABP), vasopressors and positive pressure ventilation for predominately left ventricular failure
Moderate- or high-dose inotropes (adrenaline > 0.3 μg/Kg/min equivalent) in combination with pulmonary artery vasodilator and/or vasopressors for predominately right ventricular failure
3. Inadequate organ support despite medical therapy as evidenced by
Onset of hepatic (acute transaminitis), renal (anuria or rising creatinine) dysfunction or skin hypoperfusion (mottled or purpuric)
Lactate > 4 mmol/L
4. Malignant arrhythmia: refractory ventricular fibrillation or tachycardia not otherwise controlled
  1. *Rapidly progressive (6 to 12 hours) lung infiltrates and increasing ventilator requirements particularly in the early stages of hospital admission are often associated with a fulminate illness that reduces the time window when ECMO may be of benefit.