neonate absolute contraindic
irrev brain damage
severe hypoxic ischemic encephalopathy (usually s/t pulm htn)
grade >3 intraventricular hemorrh
neonate relative contraindic
< 2kg
<34 wks
sepsis
neonate respir indications- disease
ARDS
PNA
meconium aspir
trauma
heme-onc
neonate cards indications- disease
cardiomyopathy
pphn
neonate respir indications- values
OI >40
persist. pH < 7.0
high vent support w/ PIP >40 cmH2O
peds absolute contraindic
very few
risk/benefit analysis
multi organ, survivable?
severe aortic stenosis
cpr >60 min
unwitn. code
pediatric relative contraindications
premature chronic lung dis
heme/onc
end-stage hepatic/ renal failure
primary pulm htn
severe neurocompromise
intracranial hemorrhage
ped cardiac indications
post op cardiogenic shock
myocarditis
cardiomyopathy
adult respir indications- disease
refractory to primary interventions (high vent settings, inotropes, veletri/nitric oxide)
pulm edema
hypoxic respir failure
ards
PE
hypercapnic respir failure
chronic bronchitis, neuromusc dis
general acute respir failure
flu, pna, aspiration
asthma
lung tx
adult respir indications- values
p/f ratio <80
murray score 3-4
takes into account vent settings, cxr, p/f ratio and compliance (PIP, TV)
adult contraindications
active cancer
prolonged course
high PIP/FIO2 > 7 days
active ICH
adult relative contraindications
pulm hemorr
obesity
advanced age
adult cardiac indications- nonsurgical
heart failure
cardiomyopathy/ myocarditis
pulm htn
cardiogenic shock
map< 55mmHg
CI <1.8 L/min/m2
svo2 <50%
adult cardiac indications- surgical
failure to wean from bypass
Low co syndrome
cardiac arrest
shunt thrombosis
tx fail/rejection
adult cardiac contraindic
not candidate for tx or VAD
prolonged cpr
aortic insufficiency
chronic organ dysfunction
adult mixed indications
sepsis shock
airway obstruction/ surgeries
neonate special indications
exit to ecmo
cannulate after partially delivered
usually for cdh, pulm masses, severe cardiac dis
max flow neonate VA- respir v cardiac etiology
va respir- 120 ml/kg/min
va cardiac- 150-180 ml/kg/min
why may some neonates with respir dis processes need va
severe pulm htn can cause rv dysfunction- causing lv dysfunction- dec co
max flow neonate vv
150 ml/kg/min
max flow neonate ecls
180-200 ml/kg/min
max flow adult
60-80 ml/kg/min
usually 2-6L/min
