Extracorporeal membrane oxygenation in adults: A practical guide for internists

Area of Science:

• Cardiovascular Medicine
• Pulmonology
• Critical Care Medicine

Background:

• Extracorporeal membrane oxygenation (ECMO) technology has advanced, leading to increased use in adult patients.
• Despite increased application, definitive evidence supporting ECMO's benefit in adult populations remains scarce.
• Current adult ECMO use spans acute respiratory distress syndrome, bridge to transplant, and postcardiac arrest care.

Purpose of the Study:

• To review the current evidence and indications for adult ECMO.
• To focus on the principles and practical aspects of ECMO in adult patients with respiratory or cardiac failure.

Main Methods:

• Literature review of current evidence and indications for ECMO in adult patients.
• Focus on principles and practical considerations for respiratory and cardiac failure.

Main Results:

• ECMO is increasingly utilized in adult acute respiratory distress syndrome, including during the H1N1 influenza pandemic.
• ECMO serves as a crucial bridge to lung or heart transplantation.
• Application in postcardiac arrest patients is a growing area of ECMO use.

Conclusions:

• The review synthesizes current knowledge on adult ECMO, highlighting its expanding role.
• Understanding ECMO principles and practicalities is essential for managing adult respiratory and cardiac failure.
• Further research is needed to establish definitive evidence of ECMO efficacy in adult populations.