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  • Heart and Vascular Services
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Criteria for ECMO

Adult Patient Criteria

Common Adult Diagnoses/Indications

  • Influenza
  • Viral/Bacterial Pneumonia
  • Burn and Inhalation Injury
  • Traumatic Lung Injury
  • Pulmonary Contusion
  • Pulmonary Embolism
  • Post-Shock or Sepsis associated with ARDS, or other forms of reversible acute lung injury or illness
  • Acute Respiratory Distress (ARDS)

Contraindications

  • Mechanical ventilation at high settings (FIO2 > 0.9, P-plat > 30) for > 7 days.
  • Unwitnessed arrest
  • Total arrest time >60 min
  • Chest compressions not initiated within 10 minutes of arrest
  • Pre-existing sever neurological disease or injury prior to arrest
  • Age: no specific age contraindication but consider increasing risk with increasing age

Call Early If

  • Considering proning
  • Adding paralytic agent
  • Increasing mechanical ventilation
  • Patient still has single organ failure

Pediatric Patient Criteria

Common Pediatric Diagnoses/Indications

  • Best within first 7 days of mechanical ventilation at high settings
  • Influenza
  • ARDS
  • PE
  • Status Asthmaticus
  • Cardiac Failure
  • Myocarditis
  • Cardiomyopathy
  • Drug overdose
  • Refractory Pulmonary Hypertension
  • Malignant arrhythmias
  • Witnessed arrest
  • Sepsis

Relative Contraindications

  • Any infant considered old and large enough to undergo a cardiac operation is an appropriate candidate for ECLS.
  • Futility
  • CPR > 5 min without evidence of being effective

Neonate Patient Criteria

Common Neonatal Diagnoses/Indications

  • Oxygenation Index > 40 for >4 hours

Relative Contraindications

  • Oxygenation Index: Mean airway P x FiO2 x 100 ÷ Post ductal PaO2
    • Oxygenation Index >20 with lack of improvement despite prolonged (>24h) maximal medical therapy or persistent episodes of decompensation
    • Severe hypoxic respiratory failure with acute decompensation (PaO2 <40) unresponsive to intervention.
    • Progressive respiratory failure and/or pulmonary hypertension with evidence of right ventricular dysfunction or continued high inotropic requirement
    • Lethal chromosomal disorder (Trisomy 13 and 18)
    • Irreversible brain damage
    • Grade III or greater ICH
    • Irreversible organ damage (unless considered for organ transplant),
    •  <1.6 Kg birth weight
    • <34 weeks post-menstrual age because of the increased incidence of increased intracranial hemorrhage.
    • Disease states with a high probability of a poor prognosis
    • Ventilation with 100% oxygen for >/= 14 days
    • Lower grade ICH
Sidebar content
  • Heart and Vascular Services
    • Cardiac Imaging
      • Coronary Calcium Scan (Calcium Score test)
    • Cardiac Rehabilitation
    • Cardiology
      • Angina
      • Aortic Aneurysm
      • Atherosclerosis
      • Coronary artery disease
      • Echocardiogram
      • Hypertrophic Cardiomyopathy (HCM)
      • Pulmonary Hypertension
    • Cardio-Oncology
    • Cardiovascular Genetics
    • Cardiac Electrophysiology
      • Atrial Fibrillation
      • Atrial Flutter
      • Cardiac Ablation
      • Cardioneuroablation
      • Convergent Procedure
      • Heart Palpitations
      • Lead Extraction
      • Pacemaker
      • Implantable Cardioverter Defibrillator (ICD)
      • Remedē® System
    • Heart Failure
      • Cardiac Amyloidosis
      • CardioMEMS™ Heart Failure System
      • Sarcoidosis
    • Heart Surgery
      • Aortic Valve Surgery
      • Heart Transplant
      • ECMO: Heart and Lung Life Support
        • A Family Guide to ECMO
        • Criteria for ECMO
        • ECMO Training Course
        • Immediately Contact the ECMO Team
        • The Iowa Difference for ECLS Care
        • Welcome from the ECMO Director
      • Left ventricular assist device (LVAD)
    • Interventional Cardiology
      • Atherectomy
      • Complex and High Risk Interventional Procedures (CHIP)
      • Percutaneous Coronary Intervention (Angioplasty)
      • Percutaneous Ventricular Assist Device (Impella)
    • Structural heart and heart valve disease
      • Atrial Septal Defect (ASD)
      • Left Atrial Appendage Closure (Watchman Device)
      • Paravalvular Leak (PVL) Closure
      • Patent Foramen Ovale (PFO)
      • Transcatheter Aortic Valve Replacement (TAVR)
      • Transcatheter Mitral Valve Repair (MitraClip)
      • Tricuspid Valve Repair and Replacement
    • Vascular Surgery
      • Deep vein thrombosis
      • Peripheral Artery Disease
      • Thoracic Outlet Syndrome (TOS)
      • Varicose Veins and Spider Veins

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Medical Intensive Care Unit
Roy J. Carver Pavilion (RCP)
Level 5, Elevator E
1-319-356-2456
Clinic
Exterior image of UI Hospitals & Clinics
In Medical Center University
200 Hawkins Drive, Iowa City, IA 52242
Cardiovascular Intensive Care Unit (CVICU)
John W. Colloton Pavilion (JCP)
Level 4, Elevator H
1-319-356-2456
Clinic
CVICU
In Medical Center University
200 Hawkins Drive, Iowa City, IA 52242
1-800-777-8442
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