title: Retrospective report of contraindications to extracorporeal membrane oxygenation (ECMO) among adults with acute respiratory distress syndrome (ARDS).
abstract: OBJECTIVE
  To determine the incidence of contraindications to extracorporeal membrane oxygenation (ECMO) among adults with acute respiratory distress syndrome (ARDS) and assess the impact of contraindications on the number of patients receiving ECMO (case volume).
  
  
  BACKGROUND
  The extent to which contraindications may affect case volumes has not been described.
  
  
  METHODS
  Retrospective, observational study at an academic tertiary medical center. The records of 730 consecutive patients with ARDS were queried for respiratory ECMO eligibility and ECMO contraindications.
  
  
  RESULTS
  Of the 730 patients with ARDS, 168 (23.0%) met ECMO inclusion criteria and 515 (70.5%) never met ECMO eligibility due to inadequately severe disease. Among 168 patients who met ECMO inclusion criteria, 1 or more relative contraindications were present in 144 (85.7%) patients. The three most common relative contraindications were immunocompromised state (58.3%), multiorgan dysfunction (29.2%) and contraindication to anticoagulation (16.7%).
  
  
  CONCLUSIONS
  Application of relative contraindications may greatly affect ECMO case volumes.
authors.affiliation: Mayo Clinic, Department of Anesthesiology, Division of Critical Care Medicine, Rochester, MN, USA. Electronic address: bohman.john@mayo.edu.
authors.forename: J Kyle
authors.initials: JK
authors.lastname: Bohman
authors.affiliation: Mayo Clinic, Department of Anesthesiology, Rochester, MN, USA.
authors.forename: Matthew N
authors.initials: MN
authors.lastname: Vogt
authors.affiliation: Mayo Clinic, Department of Anesthesiology, Division of Critical Care Medicine, Rochester, MN, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Hyder
mesh_terms: D000328:Adult; D000368:Aged; D000075202:Contraindications; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: ARDS; Acute respiratory distress syndrome; Adult; ECMO; Extracorporeal membrane oxygenation