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Hanuola Criteria for Referral and Transport to ECMO Center

Transport Hotline: 808-983-6555 

Neonatal: >34 weeks gestation AND >2000 grams birth weight

Respiratory

Refractory respiratory failure with poor oxygenation and ventilation WITH or WITHOUT pulmonary hypertension (diagnosed clinically or with ECHO) and one of the following over a 2- 4 hour period:

1. On 100% oxygen (with inhaled nitric oxide at 5-20 ppm) and consistently maintaining paO2 values <80 on arterial blood gases
2. OI’s >25 (OI= MAP x Fio2 / PaO2 ) regardless of type of ventilator
3. pH <7.25 or Lactate >3 despite volume resuscitation and vasopressor/glucocorticoid support
4. Severe / persistent airleak

Cardiac / Shock

1. pH <7.25 or Lactate >3 despite volume resuscitation and vasopressor/glucocorticoid support
2. Refractory dysrhythmia

Congenital Diaphragmatic Hernia

• Prenatal diagnosis - Refer for peripartum care and delivery at ≥ 34 weeks’ gestation.
  Postnatal Diagnosis - Transfer at time of initial diagnosis for observation and surgical repair regardless of level of respiratory or hemodynamic support.

Pediatric: 1month-21yrs

Respiratory

Refractory respiratory failure with poor oxygenation and ventilation and one of the following
over a 12 hour period:

1. PEEP > 8cm H2O
2. PaO2/FiO2 < 150
3. PH < 7.25
4. Plateau pressure >30 cm H2O
5. Compliance < 60ml/cm H20
6. Severe persistent airleak

Cardiac / Shock

1. pH <7.25 or Lactate >3 despite volume resuscitation and vasopressor/glucocorticoid support
2. Refractory dysrhythmia