Extra‐Corporeal Membrane Oxygenation na insuficiência respiratória e circulatória agudas: uma terapêutica cada vez mais à mão

Extracorporeal membrane oxygenation (ECMO) is being increasingly used for short-term circulatory and/or respiratory support. It is derived from extracorporeal circulation systems used in cardiac surgery in which blood is propelled by a centrifugal pump through an external membrane where gas exchange takes place. The pump assists the heart and the membrane fulfills the functions of the lungs. ECMO is indicated in cases of respiratory failure such as acute respiratory distress syndrome, or cardiac failure such as myocardial infarction complicated by cardiogenic shock, which although acute carry the possibility of recovery, and in patients with advanced chronic heart failure as a bridge to transplantation or decision. Circulation is usually established via peripheral venous and/or arterial cannulation, increasingly by a percutaneous approach. There are two basic types (Figure 1): veno-venous (VV), for respiratory support; and venoarterial (VV), for circulatory and/or cardiopulmonary support.