Extracorporeal membrane oxygenation and sepsis

Area of Science:

• Critical Care Medicine
• Cardiovascular Surgery
• Pediatric Critical Care

Background:

• Extracorporeal membrane oxygenation (ECMO) is an evolving life support technology.
• Its application has expanded beyond traditional uses like acute respiratory failure and cardiogenic shock.
• Septicemia is no longer considered an absolute contraindication for ECMO.

Purpose of the Study:

• To review the technique and application of ECMO in sepsis.
• To discuss ECMO's role in managing sepsis-related hypoxemia and inadequate cardiac output.
• To highlight age-specific considerations for ECMO in sepsis.

Main Methods:

• Review of current literature and clinical experience with ECMO in sepsis.
• Description of ECMO techniques for neonatal, pediatric, and adult sepsis patients.
• Analysis of indications and outcomes for ECMO in severe sepsis.

Main Results:

• ECMO is utilized for severe sepsis, particularly acute respiratory distress syndrome and bacterial pneumonia.
• Refractory septic shock with hypotension can be an indication, more common in children.
• ECMO serves as a rescue therapy for hypoxemia or inadequate cardiac output in sepsis.

Conclusions:

• ECMO is a viable rescue therapy for select patients with severe sepsis.
• Indications and application of ECMO in sepsis vary by age group.
• Continued research and experience refine ECMO's role in critical care for sepsis.