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Table 1 Checklist prior to initiating high-risk ECMOa

From: When to initiate ECMO with low likelihood of success

1. Is long-term survival with adequate neurological and functional recovery conceivable?
2. Does the institution currently have sufficient resources and expertise? If not, is referral to another centre feasible?
3. Is the institution ready to offer long-term support after ECMO, e.g. protracted ICU stay, transplantation, home ventilation?
4. Is the patient’s family fully informed of the risks, do they understand the likely outcome and are they nonetheless supportive?
5. Is the ECMO leadership within the institution supportive?
If the answer to any of these questions is “no”, then ECMO should be reconsidered.
  1. ICU intensive care unit
  2. ECMO extracorporeal membrane oxygenation
  3. aECMO which is not actively contraindicated but where survival to hospital discharge is unlikely