Extracorporeal membrane oxygenation (ECMO), or extracorporeal life support (ECLS), is increasingly being used for a variety of cardiac and pulmonary conditions.
VenovenousECMO (VVE) should be considered in the treatment of patients with profound gas-exchange abnormalities that are refractory to accepted standards in ventilator management.
Although indications vary slightly by institution, general indications for VVE include:
Severe hypoxemia: PaO2/FiO2 < 80 despite high levels of PEEP for at least 6 hours
Uncompensated hypercapnia with pH < 7.15
Excessively high plateau pressures (> 45 cm H20)
References
Brodie D, Bacchetta M. Extracorporeal membrane oxygenation for ARDS is adults. NEJM2011;365:1905-14.
