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 diseasea |
| Pulmonary fibrosisa | |
| ARDS associated with bone marrow transplantationab |
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].