Routine Versus Selective Intraoperative ECMO in Lung Transplant

Routine ECMO during lung tansplant

"Selective, indication-based intraoperative cardiopulmonary support. In this group, the transplant will be planned without cardiopulmonary support. intraoperative ECMO will be used selectively based on hemodynamic and/or gas exchange abnormalities :~1. Inability to maintain adequate hemodynamics and stable perfusion or oxygenation during surgery~2. Prolonged high dose pressor required to maintain adequate perfusion~3. A sustained drop in cerebral saturation \> 25% of baseline despite initial attempts at optimization~4. Inability to tolerate pulmonary artery clamping~5. Inadequate gas exchange despite attempts at the optimization of ventilator parameters and treatments related to respiratory mechanics and ventilation/perfusion matching~6. Inadequate exposure to the surgical field"