Internal Medicine

Extracorporeal membrane oxygenation (ECMO)


Extracorporeal membrane oxygenation (ECMO), also known as extracorporeal life support (ECLS), is an extracorporeal technique of providing prolonged cardiac and respiratory support to persons whose heart and lungs are unable to provide an adequate amount of gas exchange or perfusion to sustain life.

  • Derivative of cardiopulmonary bypass (provides shorter-term support with arrested native circulation)


ECLS was initially developed in the 1950s by John Gibbon as a means of oxygenating blood via a membrane oxygenator during prolonged operations on cardiopulmonary bypass.


  • Veno-arterial ECMO (VA-ECMO):
    • Facilitates gas exchange
    • Provides haemodynamic support (blood pumped from venous to arterial side)
  • Veno-venous (VV-ECMO):
    • Facilitates gas exchange (blood removed from venous side and pumped back)
    • Does not provide haemodynamic support
  • Arterio-venous ECMO (AV-ECMO):
    • Facilitates gas exchange (by using the patient’s own arterial pressure to pump the blood from arterial to venous side)


Weaning from cardiopulmonary bypass after cardiac surgery Any potentially reversible acute respiratory failure
Bridge to cardiac transplantation ARDS. Associated with pneumonia (viral or bacterial)
Acute myocarditis Failed lung transplant graft
Intractable arrhythmia Trauma (pulmonary contusion)
Post-cardiac arrest (as part of Advance Life Support) Pulmonary embolism (if acceptable cardiac function)
Local anaesthetic toxicity
Pulmonary hypertension (after pulmonary endarterectomy)


  • Major complications:
    • Haemorrhage
    • Infection
  • Other complications:
    • ECMO circuit failure or breakage

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