|Refractory CS in the setting of||Absolute|
|Have less invasive therapies been exhausted?|
In the event of no myocardial recovery, does the patient have an “exit strategy”?
For centers without ECMO capabilities, is timely collaboration with a high-volume ECMO center feasible?
Is the anticipated duration of needed support compatible with available technology?
Has the optimal time window for ECMO deployment expired (i.e., will ECMO be medically futile)?
Have all the key players been involved in the decision-making process (e.g., cardiologists, surgeons, heart failure specialists, intensivists, palliative care specialists)?
Are the patient’s wishes for advanced therapies known?
CS = cardiogenic shock; ECMO = extracorporeal membrane oxygenation; MCS = mechanical circulatory support; VA-ECMO = venoarterial extracorporeal membrane oxygenation.