Are There Contraindications to ECMO Referrals?

I wish we would stop calling it ECMO referral centers and they became respiratory failure referral centers. I think the biggest thing is making sure that you are doing your best to ventilate them safely. The kind of only absolute contraindication is disease expected non-recovery with no viable decanulation options, i.e. end stage COPD or interstitial lung disease not a transplant candidate.