A review of the fundamental principles and evidence base in the use of extracorporeal membrane oxygenation (ECMO) in critically ill adult patients.
Extracorporeal membrane oxygenation (ECMO) comprises a commonly used method of extracorporeal life support. It has proven efficacy and is an accepted modality of care for isolated respiratory or cardiopulmonary failure in neonatal and pediatric populations. In adults, there are conflicting studies regarding its benefit, but it is possible that ECMO may be beneficial in certain adult populations beyond postcardiotomy heart failure. As such, all intensivists should be familiar with the evidence-base and principles of ECMO in adult population. The purpose of this article is to review the evidence and to describe the fundamental steps in initiating, adjusting, troubleshooting, and terminating ECMO so as to familiarize the intensivist with this modality.
Department of Surgery, Division of Traumatology and Surgical Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Steve
S
Allen
Daniel
D
Holena
Maureen
M
McCunn
Benjamin
B
Kohl
Babak
B
Sarani
D000328:Adult; D000075202:Contraindications; D016638:Critical Illness / Q000628:therapy*; D019317:Evidence-Based Medicine; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation; D006801:Humans; D012131:Respiratory Insufficiency / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000628:therapy*