ECMO-/ECLS

over a longer period of time, especially in view of the high incidence of stenosis.
At our institution, we do not routine perform reconstruction of the carotid artery.
Considerations for discontinuing extracorporeal support at times other
than when indicated by improvement of cardiopulmonary function include the
presence of irreversible brain damage, other lethal organ failure, and
uncontrollable bleeding. Those neonates with congenital diaphragmatic hernia
or pneumonia and pediatric patients with cardiac or pulmonary failure may
require substantially longer periods on ECLS before resolution of the
cardiopulmonary process is observed. Judgment must be utilized regarding the
reversible nature of the respiratory dysfunction, the presence of associated organ
system failure, and the development of complications associated with ECLS in
determining whether continuation of extracorporeal support is warranted after
prolonged periods on ECLS.