Extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) has been considered a miniature adaptation of conventional cardiopulmonary bypass machine for cardiopulmonary support using intrathoracic (central) or extrathoracic (peripheral) cannulation to provide continuous, nonpulsatile blood circulation and extracorporeal blood gas-exchange (oxygenation and decarboxylation), keeping patients alive in the intensive care unit until for definitive therapy or complete recovery of underlying pathology. Basically, the drainage cannula drains patient’s venous blood through a suction effect (negative pressure) via a centrifugal pump that circulates the venous blood outside the body and propels it into a semipermeable, artificial membranous oxygenator, where oxygen is delivered to the blood and carbon dioxide is removed, and the oxygenated blood is reinfused back into the body through a return cannula inserted either in a central venous system (veno-venous ECMO) or arterial system (veno-arterial ECMO), or combined (veno-arteriovenous ECMO). As technology progressed and its use expanded, a new area for ECMO has developed for nonsurgical patients who suffered from various pathologies, such as pandemic respiratory failure, in- or out-of-hospital cardiac arrest, poisoning, deep hypothermic arrest, or inhalation toxicity. Transport–ECMO is a lifesaving strategy to bring patients to specialized ECMO-centers after emergency ECMO support has been established. After successful healing or bridging, ECMO wean procedures should be applied with very strict rules to avoid from resupport.