• Eddy Fan, Luciano Gattinoni, Alain Combes, Matthieu Schmidt, Giles Peek, Dan Brodie, Thomas Muller, Andrea Morelli, V Marco Ranieri, Antonio Pesenti, Laurent Brochard, Carol Hodgson, Cecile Van Kiersbilck, Antoine Roch, Michael Quintel, and Laurent Papazian.
• Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. eddy.fan@uhn.ca.
• Intensive Care Med. 2016 May 1; 42 (5): 712-724.

AbstractDespite expensive life-sustaining interventions delivered in the ICU, mortality and morbidity in patients with acute respiratory failure (ARF) remain unacceptably high. Extracorporeal membrane oxygenation (ECMO) has emerged as a promising intervention that may provide more efficacious supportive care to these patients. Improvements in technology have made ECMO safer and easier to use, allowing for the potential of more widespread application in patients with ARF. A greater appreciation of the complications associated with the placement of an artificial airway and mechanical ventilation has led clinicians and researchers to seek viable alternatives to providing supportive care in these patients. Thus, this review will summarize the current knowledge regarding the use of venovenous (VV)-ECMO for ARF and describe some of the recent controversies in the field, such as mechanical ventilation, anticoagulation and transfusion therapy, and ethical concerns in patients supported with VV-ECMO.

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