• Neurologic catastrophe (e.g., cerebral hemorrhage, infarction, edema)

• Moribund state/terminal condition with markedly reduced life expectancy

(<6 months)

• Advanced, incurable underlying disease (e.g., malignancy; cirrhosis;

pulmonary hypertension, cardiac failure, severe fibrotic or obstructive lung

disease—except cases in which ECMO is being used as a bridge to

transplant or ventricular assist device placement)

• Lack of informed consent

• Contraindication to anticoagulation (e.g., severe or uncontrolled bleeding)

• Advanced age (>70 years)

• Multisystem organ failure

• Duration of mechanical ventilation greater than 7-10 days

• Marked obesity (weight >150 kg; due to excessive flow demands on the

circuit)

• Inexperienced center; resources not organized to provide ECMO

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