Extracorporeal Membrane Oxygenation in Nontraumatic Critical Care: New Horizons in Resuscitation

Abstract

Extracorporeal membrane oxygenation (ECMO) transfers blood from a large vein into a machine, oxygenates it, and then reinfuses the oxygenated blood back to the patient through a large vascular catheter. Resuscitation procedures using ECMO are known as extracorporeal cardiopulmonary resuscitation or extracorporeal life support. On one hand, the procedure is suitable for selected patients with severe respiratory diseases, cardiogenic or septic shock, intoxications, thyrotoxicosis, trauma, or cardiac arrest. On the other hand, geriatric persons with multiple diseases, end-stage malignancies, those with cardiopulmonary diseases, or dementia are not candidates for extracorporeal cardiopulmonary resuscitation (ECPR). The potential indications for ECMO are still expanding, but well-designed, multicentric studies are needed to assess benefit and harms.