Extracorporeal membrane oxygenation for acute cardiopulmonary failure

ECMO is an established therapy to support the acutely failing lungs and/or heart. It provides physiologic stabilization, oxygenation, and ventilatory support of the patient while definitive therapies allow for recovery. ECMO is a resource-intensive therapy that requires close collaboration of an extensive multidisciplinary team of providers. Despite growing experiences, better tools for patient selection and protocols for management, and advances in technologies to overcome some of the challenges of supporting a patient on an extracorporeal circuit, outcomes are still less than ideal. Without a doubt, early initiation of therapy can reduce the risk of irreversible end-organ damage while promoting recovery, but patient selection remains a challenge. Many of the complexities, controversies, and management difficulties associated with ECMO still need to be addressed before there is a broader adoption of this therapy as a first-line tool in the management of critically ill patients.