Which of the following is a contraindication for ECMO?

Severe irreversible lung disease is a contraindication for extracorporeal membrane oxygenation (ECMO) because the primary purpose of ECMO is to provide temporary support for infants with significant respiratory or cardiac failure that is potentially reversible. In cases where lung disease is irreversible, the likelihood of ECMO providing any useful benefit diminishes significantly. Since ECMO is utilized to bridge patients toward recovery or a definitive intervention, permanent conditions that cannot improve negate the potential positive outcomes of using ECMO. Thus, if an infant has a severe, irreparable lung condition, the risks associated with ECMO intervention would outweigh any potential advantages.

The other options reflect conditions under which ECMO might still be considered or would not typically preclude its use. For example, being greater than 34 weeks gestation or weighing over 2 kg are generally not contraindications, as ECMO can be employed in appropriately selected infants of this size and age. A stable infant without anomalies could potentially be a candidate for ECMO if they present with reversible conditions requiring such support.