Extracorporeal Membrane Oxygenation: Indications, Technique and Contemporary Outcomes

Extracorporeal membrane oxygenation (ECMO) is an advanced form of temporary life support, to aid respiratory and/or cardiac function. It has been used since the early 1970s and is based on cardiopulmonary bypass technology and diverts venous blood through an extracorporeal circuit and returns it to the body after gas exchange through a semi-permeable membrane. ECMO can be used for oxygenation, carbon dioxide removal and haemodynamic support. Additional components allow thermoregulation and haemofiltration. The two most common forms of ECMO are veno-venous (VV) and veno-arterial (VA). In VV-ECMO, used to support gas exchange, oxygenated blood is returned to a central vein. In VA-ECMO, used in cases of cardiac or cardiorespiratory failure, oxygenated blood is returned to the systemic arterial circulation, bypassing both the heart and lungs.