Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Apr-Jun;14(2):110-119.
doi: 10.14797/mdcj-14-2-110.

The Role and Impact of Extracorporeal Membrane Oxygenation in Critical Care

Iqbal Ratnani  1 , Divina Tuazon  1 , Asma Zainab  1 , Faisal Uddin  1
Affiliations
Review

The Role and Impact of Extracorporeal Membrane Oxygenation in Critical Care

Iqbal Ratnani et al. Methodist Debakey Cardiovasc J. 2018 Apr-Jun.

Abstract

Use of extracorporeal membrane oxygenation (ECMO) has been exponentially increasing over the last decade and is now considered a mainstream lifesaving treatment modality in critical care medicine. However, the need for physician education, training, and experience remains imperative. Although ECMO has traditionally been used in end-stage lung disease and circulatory collapse, it is being adopted for use in right heart failure, as a bridge to heart and lung transplantation, and as rescue therapy for both sepsis and post-organ transplantation. The following article discusses indications, management, complications, and challenges of ECMO as well as our experience at the Houston Methodist DeBakey Heart & Vascular Center.

Keywords: ARDS; ECMO; acute respiratory distress syndrome; cardiogenic shock; extracorporeal membrane oxygenation; heart transplant; lung transplant; right heart failure; sepsis.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Figures

Figure 1.
Figure 1.
The PROTEK Duo veno-venous cannula (CardiacAssist, Inc.) provides venous drainage and reinfusion of blood through an internal jugular vein while on ECMO support.
Figure 2.
Figure 2.
Typical femoral veno-venous cannulation.
Figure 3.
Figure 3.
Pharmacy-managed anticoagulation protocol for patients on extracorporeal membrane oxygenation.
Figure 4.
Figure 4.
Decrease in mortality at the Houston Methodist DeBakey Heart & Vascular Center achieved by instituting a multidisciplinary team approach. VV: venovenous; VA: venoarterial
See this image and copyright information in PMC

References

    1. Rubenfeld GD, Caldwell E, Peabody E, . et al. Incidence and outcomes of acute lung injury. N Engl J Med. 2005. October 20; 353 16: 1685– 93. - PubMed
    1. Brower RG, Matthay MA, Morris A, . et al. .; Acute Respiratory Distress Syndrome Network Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000. May 4; 342 18: 1301– 8. - PubMed
    1. Brogan TV, Thiagarajan RR, Rycus PT, Bartlett RH, Bratton SL.. Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database. Intensive Care Med. 2009. December; 35 12: 2105– 14. - PubMed
    1. Makdisi G, Wang IW. Extra Corporeal Membrane Oxygenation (ECMO) review of a lifesaving technology. J Thorac Dis. 2015. July; 7 7: E166– 76. - PMC - PubMed
    1. Napp LC, Kühn C, Hoeper MM, . et al. Cannulation strategies for percutaneous extracorporeal membrane oxygenation in adults. Clin Res Cardiol. 2016. April; 105 4: 283– 96. - PMC - PubMed

MeSH terms