Table 6. Summary of technical ECMO failure and diagnosis.
| Type of failure | Monitoring Parameter | Acceptable value on ECMO | Value suggesting malfunction |
| Oxygenator thrombosis | Visual inspection | No/minimal clot formation | Pronounced/subtotal clotting |
| dpMO (mmHg)/ECMO blood flow (l/min) | Device dependent [15] | 30–50% increase in dpMO | |
| DDimers | <10 mg/l | >25–30 mg/l | |
| platelets | >50/nl | Continuous or rapid decrease | |
| Device-related coagulation disorder | Fibrinogen | >200 mg/dl | <200 mg/dl |
| Gas exchange failure | PO2 post MO | >400 mmHg | <200 mmHg |
| PCO2 post MO (with 10–12 l/min sweep gas flow) | <30 mmHg | >40–45 mmHg or PCO2 pre MO – PCO2 post MO<5 mmHg | |
| Clots in pumphead | LDH | <350 U/l | Rapid and substantial increase (>1000 U/l) |
| Free Hb | <50–100 mg/l | Rapid and substantial increase (>300 mg/l) | |
| potentially platelets | >50/nl | rapid decrease | |
| Sound of the pump | Normal silent noise | Abnormal noise/vibration of pump head |
Type of ECMO failure and predictors with acceptable values during ECMO and values suggesting failure. These are not solely pathognomonic and not all predictors have to be present in specific types of ECMO failure. Differential diagnoses always have to be ruled out before pathologic values can be attributed to a failing ECMO system. Different types of failure can appear together and a decision for a system-exchange is often multifactorial.