How I Approach Membrane Lung Dysfunction in Patients Receiving ECMO

With improvements in circuit technology and expanding supportive evidence, extracorporeal membrane oxygenation (ECMO) use has grown rapidly over the past decade. Advances in pump and membrane lung (ML) design have led to simpler and more efficient circuits. Circuit-related complications, however, remain frequent and associated with considerable morbidity.

The decision to exchange a ML is complex and without clear guidelines. In this manuscript, we outline a physiologic approach to troubleshooting this common yet high risk event.