Extra-Corporeal Membrane Oxygenation

Collaborating with his wife Mary, Dr. John Gibbon developed extracorporeal cardiopulmonary circuits after witnessing a patient die after a pulmonary embolectomy in 1931. He then performed the first successful use of cardiopulmonary bypass to close an atrial septal defect in an 18-year-old woman in 1953 (Hill et al., Ann Thorac Surg. 34:337–41, 1982; Gibbon Minn Med 37:171–85, 1954). The first prolonged use of extracorporeal membrane oxygenation circuits (ECMO) in critically ill patients was only later reported after it was used to treat a trauma patient with acute respiratory distress syndrome (ARDS) in 1972 (Sinard and Bartlett Perfusion. 5:239-249, 1990). Dr. Robert Bartlett went on to establish ECMO as a treatment for neonatal respiratory distress after he successfully treated a patient with meconium aspiration in 1975 (Bartlett, ASAIO J 63:832–843, 2017). Since then, ECMO use in adult populations has increased tenfold due to technology improvements and expansion in its indications ( https://www.elso.org/registry/internationalsummaryandreports/internationalsummary.aspx ). It is therefore important for all clinicians to have some familiarity with ECMO basics. Here, we describe the essentials of ECMO cannulation and management for senior medical students.