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Types of ECLS in the intensive care unit

Types of ECLS in the intensive care unit
ECLS type ECLS mode and configuration Organ support and function Suggested indications*
ECMO V-V ECMO Respiratory support (oxygenation and CO2 removal) Refractory ARDS, bridge to lung transplant, severe primary graft dysfunction after lung transplant, severe reperfusion pulmonary edema after thromboendarterectomy, aspiration
V-A ECMO Cardiac/circulatory support (circulatory support, oxygenation and CO2 removal) Refractory cardiogenic shock, ECPR, decompensated pulmonary vascular disease, postcardiotomy shock, others (trauma, anaphylactic shock, drowning, organ donation, shock due to overdose, hypothermia)

V-VA ECMO

V-AV ECMO 		Cardiorespiratory support Mixed components of the above indications
ECCO2R

V-V ECCO2R

A-V ECCO2R 		CO2 removal only Refractory hypercapnic respiratory failure (eg, status asthmaticus, bridge to lung transplantation); facilitation of lung protective ventilation strategies in ARDS (under investigation)
NOTE: This table excludes cardiopulmonary bypass for cardiothoracic or vascular surgery.

ECLS: extracorporeal life support; ECMO: extracorporeal membrane oxygenation; V-V: venovenous; CO2: carbon dioxide; ARDS: acute respiratory distress syndrome; VA: venoarterial; ECPR: extracorporeal cardiopulmonary resuscitation; V-VA: venovenoarterial; V-AV: venoarteriovenous; ECCO2R: extracorporeal carbon dioxide removal; A-V: arteriovenous.

* In most instances, ECMO is offered when standard therapies have failed.
Adapted from: Conrad SA, Broman LM, Taccone FS, et al. The Extracorporeal Life Support Organization Maastricht Treaty for nomenclature in extracorporeal life support. A position paper of the Extracorporeal Life Support Organization. Am J Respir Crit Care Med 2018; 198:447.
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