Extracorporeal membrane oxygenation for acute respiratory distress syndrome

Table 1 Indication and contraindications of ECMO for ARDS

Indication	Contraindications
Acute reversible lung disease when conventional therapy cannot sustain life	The following underlying diseases
Severe hypoxaemia (PaO₂/FiO₂ ratio <80 mmHg)	Advanced cancer
Uncompensated hypercapnia (pH <7.20)	Chronic lung disease^a
	Pulmonary fibrosis^a
	ARDS associated with bone marrow transplantation^ab

ECMO, extracorporeal membrane oxygenation; ARDS, acute respiratory distress syndrome; PaO₂, arterial partial pressure of oxygen; FiO₂, fraction of inspired oxygen
^aIf the patient is a candidate for lung transplantation, ECMO can be considered.
^bWhile leukaemia is a good indication, ARDS associated with bone marrow transplantation is different. All of our patients with ARDS after bone marrow transplantation developed pulmonary fibrosis during ECMO, so we do consider that ECMO is not suitable for severe ARDS associated with bone marrow transplantation. The same result has been reported based on the data from the ELSO registry [52].

ISSN: 2052-0492