Timing of when to initiate extracorporeal membranous oxygenation.
| All respondents | ECMO directors (n=8) | Trauma surgeons (n=131) | Surgical intensivist (n=42) | Critical care fellows (n=8) | |
| Timing of ECMO initiation | |||||
| Failure to improve after maximizing conventional ventilation | 13.1% | 25.0% | 12.2% | 7.1% | 37.5% |
| Failure to improve after APRV/bilevel | 23.1% | 0.0% | 23.7% | 33.3% | 0.0% |
| Failure to improve after addition of prone, NO, Epo, steroids and/or surfactant | 16.6% | 25.0% | 16.0% | 16.7% | 25.0% |
| Hypoxic respiratory failure worsening but prior to maximal therapy being reached | 28.6% | 50.0% | 26.7% | 28.6% | 12.5% |
| I never consider ECMO | 10.6% | 0.0% | 12.2% | 11.9% | 0.0% |
| I do not know | 8.0% | 0.0% | 9.2% | 2.4% | 25.0% |
APRV, airway pressure release ventilation;ECMO, extracorporeal membranous oxygenation; Epo, epoprostenol; HFOV, high-frequency oscillatory ventilation; NO, inhaled nitric oxide; bilevel, bilevel ventilation; paralysis, pharmacological paralysis; prone, prone positioning; steroids, corticosteroids.