Definitions
Extra corporeal membrane oxygenation is a life-support device similar to a Heart-Lung machine. It is capable of providing both gas exchange and circulatory support for patients who have REVERSIBLE lung and/or heart failure refractory to conventional means of cardiovascular and ventilatory support.
Veno-Venous ECMO
In VV ECMO blood is drained from a central vein, oxygenated and returned to the venous system effectively bypassing the lungs. It is used to provide gas exchange support for patients with lung failure refractory to conventional ventilation.
Veno-Arterial ECMO
In VA ECMO blood is drained from a central vein, oxygenated and returned to the arterial system bypassing the heart and lungs. It is used to provide both circulatory and gas exchange support for patients with heart and /or lung failure refractory to inotropes, intra-aortic balloon counterpulsation and ventilation. It can also be deployed during cardiac arrest as ECMO CPR.
ECMO Referral Contacts
New South Wales (02) 9553 2222
Via the Medical Retrieval Unit of Ambulance NSW
Victoria 1300 36 86 61
Queensland 1300 799 127
Via Retrieval Services Queensland
Other States
No formal structure in place. Contact an established ECMO referral centre for advice.
General Exclusion Criteria
- Age: > 70 years
- Active malignancy
- Severe brain injury
- Previous Bone marrow transplant
- Previous heart, lung, renal transplant (>30 days)
- AIDS defining illness despite antiretroviral therapy
- Cirrhosis
- End-stage renal failure (dialysis)
Specific Exclusions VV ECMO
- Chronic lung disease not eligible for transplant
- Profound shock with multiorgan failure
Specific Exclusions VA ECMO
- Aortic dissection
- Severe aortic regurgitation