The increasing complexity of contemporary critical care units and improvements in health care technology is mirrored by an increase in the use of extracorporeal membrane oxygenation (ECMO). The use of ECMO therapy is escalating, from 2354 cases at 125 ECMO centers in 2010 to nearly 11 000 cases at 265 centers in 2019. ECMO supports critically ill patients with refractory cardiac and/or respiratory failure and is reserved for the sickest of patients who likely would otherwise die before their heart and/or lungs could recover. It has the potential to benefit patients across the life span, from neonates to older adults. While ECMO is a life-saving therapy and serves as a bridge between cardiorespiratory failure and disease recovery or transplant, it presents substantial risks of significant morbidity and mortality.

Although the ECMO circuit has traditionally been managed by perfusionists,...

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