Extracorporeal Oxygenation (ECMO) in Patients with Acute Respiratory Failure

Abstract: Extracorporeal membrane oxygenation (ECMO) is a method for oxygenation and removal of carbon dioxide in patients with respiratory failure in whom we cannot achieve that with standard methods of invasive mechanical ventilation. The method works as an extracorporeal bypass of blood, which we take from one central vein, then the blood goes through an oxigenator and returns oxygenated and free of carbon dioxide to another central vein. The system is run by a pump with steady non-pulsatile flow. We use two standard ECMO types. For respiratory failure alone we use veno-venous ECMO and for heart failure we use veno-arterial ECMO. We can also combine more types of ECMO according to the patient´s needs. We started using ECMO in 2009, with the number of patients is increasing every year. The majority of patients with the need of ECMO has influenza, pneumococcal pneumonia or infection with Legionella species. We also used ECMO a lot during COVID-19 pandemic. With this new method even the patients who would otherwise (even 10 years ago) die of respiratory failure, have a greater possibility to survive. Keywords:ECMO – extracorporeal membrane oxygenation, respiratory failure, cannulas, non-pulsatile blood flow