UMEM Educational Pearls

Situations Where ECMO Will Likely Fail

  • As many EDs and ICUs begin to develop protocols for the use of ECMO, it is important to note select conditions when this therapy is unlikely to be succesful.
    • Chronic respiratory or cardiac disease with no hope of recovery
    • OHCA with prolonged no blood flow
    • Severe aortic regurgitation
    • Type A aortic dissection
    • Refractoroy septic shock with preserved LV function
    • Stem cell transplant patients
    • Advanced age with ARDS
    • Prolonged pre-ECMO mechanical ventilation (> 7 days)
    • Center inexperienced with ECMO

References

Schmidt M, et al. Ten situations in which ECMO is unlikely to be successful. Intensive Care Med 2016; 42:750-752.