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Extracorporeal Membrane Oxygenation: How Do We Do It?

  • Pablo G. Sanchez
  • Aaron M. Cheng
Chapter

Abstract

ECMO support should be considered whenever a critically ill patient has severe respiratory or cardiorespiratory failure and conventional circulatory or respiratory therapy has failed or is anticipated to be inadequate to support vital organ function. Intuitively, like most acute life-supportive interventions, the earlier ECMO support is initiated when required, the more likely a desired clinical outcome can be achieved. Patients considered appropriate for ECMO support should have reversible clinical conditions that are expected to have realistic chances of recovery or have available options for more durable, long-term support when the primary indication is for circulatory failure. The variety of different clinical scenarios in which ECMO support has been utilized has markedly expanded over the last two decades, particularly as management of critically ill patients has improved and ECMO technology continues to evolve and is applied by a wider clinical audience. It is now important for all intensivists to have a basic understanding of ECMO principles and practices and particularly the indications for referral for consideration of ECMO.

Keywords

ECMO Respiratory failure Acute respiratory distress syndrome Extracorporeal membrane oxygenation Venovenous Venoarterial 

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Pittsburgh, Department of Cardiothoracic Surgery, Division of Lung Transplant and Lung Failure, University of Pittsburgh Medical Center, Associate Director of Lung Transplant and ECLSPittsburghUSA
  2. 2.University of Washington, Department of Surgery, Division of Cardiothoracic Surgery Co-Director, Cardiothoracic ICU, University of Washington Medical Center Director, Thoracic Surgery, Harborview Medical CenterSeattleUSA

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