[Extracorporeal Membrane Oxygenation( ECMO) as an Emerging Technology:Present and Future]

Extracorporeal membrane oxygenation (ECMO) has become an essential therapeutic modality for severe respiratory and circulatory failure. Recent technological advances have lowered the operational threshold for ECMO by enabling safer, more portable, and user-friendly systems. This article reviews the latest developments in ECMO-related technologies from the perspective of practicing clinicians. Key topics include the miniaturization and transportability of devices, improvements in centrifugal pumps and membrane lungs, and the incorporation of real-time monitoring and automatic control. Surface coatings using phosphorylcholine or hydrophilic polymers have enhanced biocompatibility and extended device longevity. Artificial intelligence and deep learning are being explored to assist in real-time decision-making and survival prediction. Furthermore, the potential for long-term implantable oxygenators is gaining attention. Our group has demonstrated prolonged in vivo function of a novel silicone membrane lung with methacryloyloxyethyl phosphorylcholine (MPC) polymer coating in large animal models, achieving thrombosis-free support for up to 100 days. The early conceptual framework for an implantable intrathoracic artificial lung, proposed by Mortensen in 1994, is gradually becoming technically feasible thanks to material and design innovations. These multifaceted advancements promise to broaden the future clinical applications of ECMO and improve outcomes across both acute and chronic indications.