The State of the Art in Extracorporeal Membrane Oxygenation.

Extracorporeal membrane oxygenation has evolved in design, technology, patient selection, insertion techniques, adjunct devices, and management in the past 45 years since it began. Outcomes have improved and indications have expanded. It continues to be an expeditious, cost-effective tool for rapid resuscitation of patients with cardiorespiratory failure, whose outcomes without extracorporeal membrane oxygenation intervention are predominately fatal. However, results are still moderately satisfactory, and the ethical aspects of ongoing care need to be at the forefront of daily family discussions in patients for whom a bridge to transplant or definitive device is not possible.