Table 1 Criteria for treatment with extracorporeal gas exchange used in different centres
From: Extracorporeal membrane oxygenation for severe acute respiratory failure
Center(s) [Reference] | Fast entry criteria | Slow entry criteria |
|---|---|---|
Orange County Medical Center, Peter Bent Brigham Hospital, Hospital of the University of Pennsylvania, Pacific Medical Centre, Latter-day Saints Hospital, Mount Sinai Hospital NYC, University of North Carolina, University of California S.F., Massachusetts General Hospital, USA [92] | PaO2<50 mmHg for >2 h at FiO2 1.0; PEEP≥ 5 cmH20 | PaO2<50 mmHg for >12 h at FiO2 0.6; PEEP ≥5 cmH2O; maximal medical therapy >48 h |
University of Milan, Italy [30] | Same as [92] | Same as [92] plus QS/QT>30%; CTstat<30 ml/cmH2O |
Karolinska Hospital, Stockholm, Sweden [43] | Same as [92] | Same as [92] |
Philipps University, Marburg, Germany [72] | A-aDO2>525 mmHg; CTstat<30 ml/cmH2O; PIP >35 cmH2O; extended infiltrations on chest X-ray; maximal medical therapy for >24 h (No distinction between fast and slow entry criteria) | |
Charité/Campus Virchow, Humboldt-University Berlin Germany [10]; Heartlink ECMO-Centre, Leicester, UK | PaO2/FiO2<50 mmHg for >2 h; PEEP ≥10 cmH2O | Maximal medical therapy for 24-120 h; PaO2/FiO2<150 mmHg; PEEP ≥10 cmH20; QS/QT≥30% at FiO2 1.0; EVLW ≥15 ml/kg bodyweight; CTstat≤30 ml/cmH2O or recurrent barotrauma |
Cochin University Hospital, Paris, France [39] | Same as [92] plus Murray score [93] >2.5; failure to improve respiratory parameters with different modes of mechanical ventilation | Same as [92] plus Murray score [93] >2.5; failure to improve respiratory parameters with different modes of mechanical ventilation |
Freiburg University Hospital, Freiburg, Germany [94] | PaO2≤50 mmHg; FiO21.0; PEEP≥10 cmH2O | FiO2≥0.7; PEEP≥10 cmH2O; maximal medical therapy for >48 h |
University of Michigan Medical School, Ann Arbor, USA [40] | Optimal conventional therapy; QS/QT>30%; CTstat<0.5 ml/cmH2O/kg bodyweight; diffusely abnormal chest radiography in four quadrants (No distinction between fast and slow entry criteria) | |
University of Utah, School of Medicine, Salt Lake City, USA [31] | Same as [92] | Same as [92] |
Ludwigs-Maximilians-University, Munich, Germany [95] | PaO2/FiO2<50 mmHg; at PEEP≥5 cmH2O for >2 h; CTstat≤30 ml/cmH2O | After 48-96 h conventional therapy, 3 out of 4 criteria must be fulfilled: PaO2/FiO2<150 mmHg at PEEP ≥5 cmH2O for >2 h; PaCO2 ≥60 mmHg at VE≥200 ml/kg; PIP ≥40 cmH CTstat≤30 ml/cmH2O and QS/QT≥30% |
Toronto General Hospital, Toronto, Canada [96] | Patients with combined cardiorespiratory compromise that is life threatening; patients with predominantly respiratory failure that is progressive and with a level of oxygenation thought to be incompatible with life; patients placed on ECMO semielectively to provide support during a procedure (No distinction between fast and slow entry criteria) | |
University of Vienna, Austria [14] | PaO2/FiO2<70 mmHg at PEEP >10 cmH2O for 96 h | Â |