2014 Volume 21 Issue 4 Pages 313-321
Extracorporeal membrane oxygenation (ECMO) has been selected for the treatment of moribund patients with severe respiratory failure unresponsive to conventional ventilatory therapy. A high-flow veno-venous (arterial) bypass using a long-term durable pump and membrane oxygenator was utilized for oxygenation and carbon dioxide removal outside the body, which allows lung rest and provides the possibility of a cure for lung injury. The basic technique of ECMO had been established by Bartlett. ECMO has been established as a standard mode of therapy for neonatal respiratory failure. However, it had not been regarded as a standard therapy until the CESAR trial and a successful ECMO outcome for the 2009 H1N1 influenza pandemic was reported. ECMO for severe respiratory failure requires technical expertise and proper equipment in a tertial center, which means centralization is desirable for a reasonable outcome. Also, simulation technology was shown to be useful in effective training and education.
