The use of extracorporeal membrane oxygenation (ECMO) began as a therapy for use in children, but has now become an option for care of critically ill adult patients. In ECMO, blood from the patient is circulated outside the body using a pump, passed through a membrane oxygenator to add oxygen and eliminate carbon dioxide, and then returned to the patient. This allows the heart and lungs to rest. Indications for use of ECMO may be either cardiac, such as cardiac failure due to cardiogenic shock, or respiratory such as acute lung injury or bridge to transplant.

The risk of morbidity and mortality for patients in which ECMO is instituted is high. This presents an additional set of issues for patients, families, and caregivers, such as palliative care and perhaps discussion of patient wishes. However, as with many advanced therapies, evaluation of outcomes over time may help to guide patient selection...

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