Table 2

- General indications for veno-venous (VV) extracorporeal membrane oxygenation (ECMO).

Contraindications for VV ECMO for respiratory failure:
The following are some of the contraindications for ECMO in patients with severe Acute Respiratory Distress Syndrome that should be considered before referral:
Circulatory collapse requiring cardiopulmonary resuscitation for >15 min (no extracorporeal cardiopulmonary resuscitation).
Contradictions for anticoagulation (active bleeding or recent major surgery).
Poor baseline functional status (Eastern Cooperative Oncology Group score 0-2).1 (Appendix A)
Significant comorbidities associated with poor outcomes:
Neurological (such as, stroke within the last 6 months, seizure disorder, dementia).
Respiratory (such as, severe chronic obstructive pulmonary disease [COPD], pulmonary fibrosis, cystic fibrosis).
Cardiac (such as, severe heart failure with left ventricular election fraction <30% from any cause, history of major cardiac intervention).
Gastrointestinal (such as, severe short gut syndrome, Crohn’s disease, ulcerative colitis).
Hepatological (such as, liver cirrhosis with child-pugh B or C).
Advanced solid organ malignancy (such as, advanced-stage colon cancer).
Severe peripheral vascular disease.
Severe liver failure with elevated International Normalized Ratio and derangement of liver enzymes.
Poor neurological status (due to intracranial bleeding, cerebrovascular accident, or others).
Prolonged high setting mechanical ventilation (>7 days).
Age >65 years.
Left ventricular ejection Fraction <30% with no previous history of low ejection fraction.
Renal (such as, end-stage renal disease on hemodialysis).
Morbid obesity (body mass index > 35 kg/m2).
Immunocompromised status (such as, post-renal transplant).
Hematological malignancies within the last 5 years.