Extracorporeal membrane oxygenation (venovenous and venoarterial ECMO)

Extracorporeal membrane oxygenation (ECMO) is a lifesaving therapy that supports the patient’s respiratory and cardiovascular system. ECMO can be classified as venovenous (VV) and venoarterial (VA) based on the location of the ECMO cannulas and return of blood flow to the patient. VV ECMO supports the respiratory system, and VA ECMO provides both respiratory and hemodynamic support. In spite of increased worldwide use of ECMO and improvements in ECMO circuit technology, there continue to be significant complications associated with ECMO, including infection, bleeding, and clotting, in addition to neurologic complications such as stroke or seizures. Successfully employing ECMO requires an in-depth understanding of the physical system; the use of anticoagulation; the risk of complications; and collaboration with a multidisciplinary team including surgeons, intensivists, and ECMO technicians.