Acute, severe respiratory or cardiac failure + REVERSIBLE cause + refractory to usual treatment + high risk of death
Poor gas exchange
Compliance < 0.5ml/cmH20/kg
P:F Ratio <100
Shunt fraction >30%
Veno-venous (VV)
Pneumonia, ARDS, acute GVHD, pulmonary contusion, smoke inhalation, status asthmaticus, airway obstruction, drowning, bridge to lung transplant
Veno-arterial (VA)
Massive PE, nonischemic cardiogenic shock, failure of transplanted heart or heart-lung, cardiac or great vessel trauma, massive pulmonary hemorrhage/trauma, sepsis, anaphylaxis, drug overdose, bridge to LVAD
Poor gas exchange
Compliance < 0.5ml/cmH20/kg
P:F Ratio <100
Shunt fraction >30%
Pneumonia, ARDS, acute GVHD, pulmonary contusion, smoke inhalation, status asthmaticus, airway obstruction, drowning, bridge to lung transplant
Massive PE, nonischemic cardiogenic shock, failure of transplanted heart or heart-lung, cardiac or great vessel trauma, massive pulmonary hemorrhage/trauma, sepsis, anaphylaxis, drug overdose, bridge to LVAD
Extracorporeal membrane oxygenation
Pediatric jet ventilation
Mechanical ventilation 
Advanced airway adjuncts
Bag valve mask ventilation
Delayed sequence intubation
Noninvasive ventilation
Rapid sequence intubation