Changing criteria for the artificial lung. Historic controls on the technology of ECMO

Extracorporeal membrane oxygenation (ECMO) has developed over the past 4 decades of research to enjoy limited clinical success today as the state-of-the-art artificial lung for long-term use. The sustained efforts of clinicians, corporations, and research scientists may achieve the promise of membrane technology in the future: an implantable artificial lung. The clinical trials considered necessary for the validation of ECMO have introduced ethical and economic dilemmas for research and corporate interests, which are typical of the development of life supporting and life sustaining technologies. The evolution of patient selection criteria and techniques for clinical trials has relied on previously recorded data. This history shows that although ECMO has been applied in the past, controlled clinical trials remain controversial, and yet in both recent and retrospective studies, survival statistics have become encouraging for certain patients.