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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Types of ECLS in the intensive care unit