Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology

Abstract

Extra Corporeal Membrane Oxygenation (ECMO) indications and usage has strikingly progressed over the last 20 years; it has become essential tool in the care of adults and children with severe cardiac and pulmonary dysfunction refractory to conventional management. In this article we will provide a review of ECMO development, clinical indications, patients' management, options and cannulations techniques, complications, outcomes, and the appropriate strategy of organ management while on ECMO.

Keywords: Extra Corporeal Membrane Oxygenation (ECMO); cardiogenic shock; cardiopulmonary resuscitation; respiratory failure.

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1

Single cannula approach.

Figure 2

Veno-venous ECMO: two cannulation approach (A) femoral vein (for drainage) and right internal jugular for infusion, (B) both femoral veins are used for drainage and perfusion. ECMO, Extra Corporeal Membrane Oxygenation.

Figure 3

Peripheral veno-arterial ECMO cannulation approach: femoral vein (for drainage), (A) femoral, (B) axillary, (C) carotid, artery are used for perfusion. ECMO, Extra Corporeal Membrane Oxygenation.

Figure 4

Central veno-arterial ECMO cannulation approach. ECMO, Extra Corporeal Membrane Oxygenation.

Figure 5

Special configuration with RVAD used as ECMO. RVAD, right ventricle assisted device; ECMO, Extra Corporeal Membrane Oxygenation.

Figure 6

LV thrombus in 19 years old patient with idiopathic cardiomyopathy and LVEF 10%, a thrombus developed after central VA ECMO. LV, left ventricle; LVEF, left ventricle ejection fraction; ECMO, Extra Corporeal Membrane Oxygenation; VA, venoarterial.