Building on the past - A bridge to the future

Extracorporeal Membrane Oxygenation (ECMO) has evolved significantly over the decades, from its early experimental stages to its current use as a standard of care in intensive care medicine. ECMO devices continue to evolve rapidly. "Building on the past - a bridge to the future" emphasises balance: moving forward with a vision for the future, while drawing strength and guidance from what has come before. Understanding the past in the development of the ECMO device components such as oxygenators and pumps will guide future innovations, as will the lessons learned from complications such as clotting or the advances in anticoagulation management. The future development will bring significant improvements in portability, safety, efficiency, and accessibility of ECMO. Advances in AI-driven monitoring and predictive models, biocompatible materials, and expanded clinical applications will make ECMO a more effective and widespread tool for managing critical heart and lung failure. These innovations are likely to make ECMO available earlier, in more settings, and safer for a wider range of patients, ensuring that it continues to save lives in an increasingly diverse range of medical situations.