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Extracorporeal Membrane Oxygenation Circuitry

Lequier, Laurance MD, FRCPC1; Horton, Stephen B. PhD, CCP(Aus), CCP(USA), FACBS2; McMullan, D. Michael MD, FACS3; Bartlett, Robert H. MD4

Pediatric Critical Care Medicine:
doi: 10.1097/PCC.0b013e318292dd10
Joint Statement on Mechanical Circulatory Support

The extracorporeal membrane oxygenation circuit is made of a number of components that have been customized to provide adequate tissue oxygen delivery in patients with severe cardiac and/or respiratory failure for a prolonged period of time (days to weeks). A standard extracorporeal membrane oxygenation circuit consists of a mechanical blood pump, gas-exchange device, and a heat exchanger all connected together with circuit tubing. Extracorporeal membrane oxygenation circuits can vary from simple to complex and may include a variety of blood flow and pressure monitors, continuous oxyhemoglobin saturation monitors, circuit access sites, and a bridge connecting the venous access and arterial infusion limbs of the circuit. Significant technical advancements have been made in the equipment available for short- and long-term extracorporeal membrane oxygenation applications. Contemporary extracorporeal membrane oxygenation circuits have greater biocompatibility and allow for more prolonged cardiopulmonary support time while minimizing the procedure-related complications of bleeding, thrombosis, and other physiologic derangements, which were so common with the early application of extracorporeal membrane oxygenation. Modern era extracorporeal membrane oxygenation circuitry and components are simpler, safer, more compact, and can be used across a wide variety of patient sizes from neonates to adults.

Author Information

1Stollery Children’s Hospital, University of Alberta, Edmonton, AB, Canada.

2Faculty of Medicine, Department of Paediatrics, The University of Melbourne, Royal Children’s Hospital, Melbourne, Australia.

3Mechanical Cardiac Support and ECMO, Seattle Children’s Hospital, Seattle, WA.

4Emeritus, University of Michigan, Ann Arbor, MI.

Dr. Bartlett has received financial support from the National Institutes of Health. The remaining authors have disclosed that they do not have any potential conflicts of interest.

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©2013The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies