Clinical Procedure
 
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Relative exclusion criteria for VA ECMO

Cardiac arrest : initial rhythm asystole or > 60 mins to ROSC (or initiation of ECMO), or chronic illness, or unwitnessed, or external center, or past CABG.

Unrepaired aortic dissection
Late cardiogenic shock
1. Lactate > 15
2. Advanced microcirculatory failure with
3. Severe mottling or established purpura
4. AST or ALT > 2000 or INR > 4.5
5. Anuria > 4hrs

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The only patients that need to be sedated are patients requiring intubation for provision of PEEP to aid in left ventricular failure.

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Differential hypoxia with peripheral VA ECMO may be a positive sign in the patient with recovering cardiac function and poor lungs.

This reflects the return of pulmonary blood flow.

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