Extracorporeal Membrane Oxygenation Then and Now; Broadening Indications and Availability

Blythe E Pollack; Roxanne Kirsch; Rachel Chapman; Robert Hyslop; Graeme MacLaren; Ryan P Barbaro

doi:10.1016/j.ccc.2022.09.003

Extracorporeal Membrane Oxygenation Then and Now; Broadening Indications and Availability

Crit Care Clin. 2023 Apr;39(2):255-275. doi: 10.1016/j.ccc.2022.09.003. Epub 2022 Dec 22.

Authors

Blythe E Pollack¹, Roxanne Kirsch², Rachel Chapman³, Robert Hyslop⁴, Graeme MacLaren⁵, Ryan P Barbaro⁶

Affiliations

¹ Division of Pediatric Critical Care, University of Michigan Medical School, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA. Electronic address: bpollack@med.umich.edu.
² Division Cardiac Critical Care, Department Critical Care Medicine, 555 Univeristy Avenue, Toronto, ON, Canada M5G 1X8; Department of Bioethics, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1XB.
³ Department of Pediatrics, Division of Neonatology and the Fetal and Neonatal Institute, Children's Hospital, 4650 Sunset Blvd., Los Angeles, CA 90027, USA; Department of Pediatrics, Keck School of Medicine of University of Southern California, 1975 Zonal Ave, Los Angeles, CA 90033, USA.
⁴ Heart Institute, Children's Hospital Colorado, 13123 E. 16th Ave, Aurora, CO 80045, USA.
⁵ Cardiothoracic Intensive Care Unit, National University Health System, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
⁶ Division of Pediatric Critical Care, University of Michigan Medical School, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA; Susan B. Miester Child Health Evaluation and Research Center, Univeristy of Michigan, NCRC Building 16, 2800 Plymouth Road, Ann Arbor, MI 48109, USA.

PMID: 36898772
DOI: 10.1016/j.ccc.2022.09.003

Abstract

Extracorporeal membrane oxygenation (ECMO) is a life support technology provided to children to support respiratory failure, cardiac failure, or cardiopulmonary resuscitation after failure of conventional management. Over the decades, ECMO has expanded in use, advanced in technology, shifted from experimental to a standard of care, and evidence supporting its use has increased. The expanded ECMO indications and medical complexity of children have also necessitated focused studies in the ethical domain such as decisional authority, resource allocation, and equitable access.

Keywords: Cardiac failure; Extracorporeal life support (ECLS); Extracorporeal membrane oxygenation (ECMO); Extracorporeal membrane oxygenation to support cardiopulmonary resuscitation (ECPR); Neonatal; Pediatric acute respiratory distress syndrome (PARDS).

Publication types

Review

MeSH terms

Cardiopulmonary Resuscitation*
Child
Extracorporeal Membrane Oxygenation*
Heart Failure*
Humans
Respiratory Insufficiency*