Practical Implementation of Extracorporeal Membrane Oxygenation in the Critically Ill Surgical Patient

Extracorporeal membrane oxygenation (ECMO) is a form of mechanical support device which temporarily supports critically ill patients with severe, refractory cardiogenic shock or respiratory failure for days to weeks. ECMO is associated with a high morbidity and mortality rate and an array of common complications such as bleeding, renal failure, limb ischemia, and vascular injury. Management of the ECMO patient can be challenging for the critical care provider and requires a detailed understanding of the ECMO circuit and the underlying physiology. The challenge of managing the ECMO patient also translates into the operating room for the surgeon and anesthesiologist, as these critically ill patients often need surgical operations. Despite the risks and challenges, it remains a useful tool in the recovery for critically ill patients and its use continues to expand.