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Patient Referrals | UC Davis Health

Extracorporeal Life Support Program

Refer a Patient

To refer a patient for possible ECLS Support:

Call the UC Davis Health Transfer Center 24 hours a day at 916-784-8200 and say you would like to refer a patient for ECLS/ECMO consideration. Please call prior to cannulation to discuss your patient, if possible.

For NICU Transfers: 

833-UCD-NICU (833-823-6428)

Have patient information ready prior to making your referral

Please have the following information ready to relay to the transfer center to expedite your referral to UC Davis Health:

  1. Patient age, height and weight, BMI
  2. Brief history of present illness and diagnosis
  3. Past medical history
  4. Last vital signs and ABG result: pH, PaCO2, PaO2, HCO3, on what % of FiO2
  5. Duration of positive pressure ventilation
  6. Current ventilator settings: FiO2, Rate, Tidal volume or inspiratory pressure, PEEP, plateau pressure
  7. Respiratory Care Therapies: Proning Y/N, Paralytics Y/N, Inhaled Vasodilators Y/N
  8. Current vasoactive medications and other infusions
  9. Last neurological exam
  10. Advanced CHF or results of the most recent echocardiogram
  11. Affected Organ Status and Supportive Modalities
  12. Bleeding or Coagulopathies
  13. Immunocompromisation status

UC Davis Health ECMO Criteria

Veno-Venous ECMO (Respiratory)

Indications for V-V ECMO support

  • Severe acute hypoxemic respiratory failure/ARDS despite optimal conventional medical therapy
  • Severe air leak syndromes
  • Acute respiratory failure in patients actively listed for lung transplantation
  • Bridge to recovery or decision

V-A ECMO (Cardiac)

Indications for V-A ECMO support

  • Cardiogenic Shock: with or without MI, myocarditis, peripartum cardiomyopathy, post cardiotomy
  • Septic Shock
  • Pulmonary Embolus (PE)
  • Non-Ischemic cardiomyopathy (NICM)
  • Failure to wean from cardiopulmonary bypass
  • Refractory malignant arrhythmias
  • Bridge to recovery or decision to a VAD and transplant

Relative Contraindications – V-V ECMO

*Early referral for ECMO support in respiratory failure is encouraged when not responding to optimal medical therapy

  • ARDS with prolonged high level positive pressure or mechanical ventilatory support (>7-10 days)*
  • Age >70
  • BMI >50
  • Cardiogenic or obstructive shock (consider VA ECMO) or refractory septic shock

Relative Contraindications – V-A ECMO

  • Age >70 years of age
  • Intubation and mechanical ventilation >7-10 days
  • BMI >50

COVID Considerations – V-V ECMO

  • Preferred age for ECLS support for ARDS/Cardiogenic shock with COVID-19 is <60 years of age
  • Length of time of intubation should be less than 5 days, also taking into account total length of illness

Contraindications for ECMO

  • Injuries or anatomy were cannulation not technically feasible
  • Decision to limit therapeutic interventions
  • Active cancer (progressive on treatment)
  • Incurable cancer (2 year survival <50%)
  • Irreversible heart failure ineligible for transplant, or durable VAD
  • Chronic organ dysfunction: emphysema, cirrhosis, chronic dialysis dependence (with exception if a bridge to transplant of that organ)
  • Prolonged CPR (>10 min) without adequate tissue perfusion/ROSC, pH <7.1 CO2 >100
  • Severe coagulopathy or life threatening hemorrhage not amenable to immediate intervention
  • Contraindication to anticoagulation