Case of the Month #40 ARDS (Acute Respiratory Distress Syndrome)

ECMO is ExtraCorporeal Membrane Oxygenation. The extracorporeal circuit allows for the oxygenation and removal of carbon dioxide from blood and is used as a supportive strategy in patients who have a high risk of death despite conventional therapy. 

Indications include acute, severe, reversible respiratory failure with a high risk of death that is refractory to conventional management. 

Some contraindications of ECMO include: 

a) Absolute: 

• Progressive non-recoverable cardiac disease (not transplant candidate) 

• Progressive and non-recoverable respiratory disease (irrespective of transplant status) 

• Chronic severe pulmonary hypertension 

• Advanced malignancy 

• Graft versus Host disease 

• Weight >120kg 

• Unwitnessed cardiac arrest 

b) Relative: 

• Age > 75 years 

• Multi-trauma with multiple bleeding sites 

• CPR > 60 minutes 

• Multiple organ failure 

• CNS injury