Table 1. Current indications for V-V ECLS

V-V ECMO

Severe ARDS with one of following, after optimization of MV [18]:

• PaO₂/FiO₂ < 50 mmHg with FiO₂ ≥ 0.8 for > 3 h

• PaO₂/FiO₂ < 80 mmHg with FiO₂ ≥ 0.8 for > 6 h

• pH < 7.25 (with PaCO₂ ≥ 60 mmHg) for > 6 h (with RR increased to 35 bpm)

V-V ECCO₂R

• Moderate ARDS with P_plat > 30 cmH₂O after optimization of MV [19]

• Acute hypercapnic exacerbation of COPD, with two of following, after 2 h of NIV [20]:

– arterial pH ≤ 7.25

– RR ≥ 30 bpm

– use of accessory muscles or paradoxical abdominal movements

Combined CRRT-ECCO₂R

Mild or moderate ARDS with AKI needing CRRT [21]