Although we’re far from the development of a Darth Vader-esque life support system, ECMO or extracorporeal membrane oxygenation has come a long way in recent years. Although initially a means of therapy used to help newborn babies, an increasing number of adults are receiving ECMO, and ECMO centers are popping up all over the world.

According to the Extracorporeal Life Support Organization (ELSO), which keeps running tabs on ECMO, ever since 1990, ECMO has been used to help 58,842 people throughout the world, with that number increasing every year. Although nearly half of these cases involve neonates with respiratory problems, a combined 10,426 cases involve adults with respiratory and cardiac problems or in need of pulmonary resuscitation.

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ECMO machine

Overview

ECMO is often used to take stress off the lungs and heart for several days, which theoretically promotes healing. It’s used in patients who, if emergently treated, their chances of survival are good, and who would otherwise probably die without ECMO.

Here are the components of a typical ECMO:

1:46Click Play to Learn How ECMO Machines Work

1:46

Click Play to Learn How ECMO Machines Work

Patients who are on ECMO are usually very sick, and not everyone survives the experience. In 2013, ELSO reported that worldwide only 72 percent of people survived ECMO with this statistic being heavily weighed in favor of neonates who have limited lung injury going into the procedure. (Keep in mind that babies have new lungs and thus often enter ECMO without the comorbidity or accompanying lung damage typical of adults.) Moreover, although 72 percent of all people survived ECMO, only 60 percent made it to discharge or transfer; again this statistic was weighed in favor of newborns. Specifically, only 56 percent of adults with respiratory problems made it ​to discharge or transfer.

Adverse effects of ECMO include severe internal and external bleeding, infection, thrombosis (life-threatening blood clots inside blood vessels) and pump failure. In order to mitigate the threat of thrombosis, components of ECMO are coated in heparin, a blood thinner.

When It’s Used

Here are some situations where ECMO is used in newborns:

Here are some situations where ECMO is used in older children:

The use of ECMO is finding its way into adult medicine. Although there’s a paucity of evidence supporting its universal use (namely we need large randomized-control trials in order to come up with universal guidelines), case reports, retrospective studies and so forth are emerging which suggest ECMO may be useful in a wide range of conditions. Of note, although there are no absolute contraindications for its use, some relative contraindications, in part based on expert opinion, have been suggested including a weakened immune system (immunosuppression), severe bleeding risk (marked coagulopathy), advanced age and high BMI.

Here are some situations in which ECMO is used in adults:

Two more bits of information on ECMO as it pertains to adults. First, unlike ventilators, ECMO avoids damaging the lungs through trauma (barotrauma) or atelectasis (lung collapse). Second, meta-analysis (pooled research) shows that ECMO may be of limited benefit in those receiving heart transplants, those with viral cardiomyopathy (a viral infection of the heart) and those with arrhythmias that have failed to respond to conventional treatment.

On a final note, ECMO is probably a treatment you will never have to encounter in either your life or the lives of your loved ones which is fortunate; ECMO is serious and reserved for those who are very ill. Nevertheless, ECMO represents a promising new way to help many more people. Although we may never develop a life support system that doubles as a suit of armor fitting of Darth Vader, we are further refining our understanding of stationary land short-term life support.

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Extracorporeal Life Support Organization.ECLS registry report: international summary.Parhar K, Vuylsteke A.What’s new in ECMO: scoring the bad indications.Intensive Care Med. 2014;40(11):1734-1737. doi:10.1007/s00134-014-3455-9Zangrillo A, Biondi-Zoccai G, Landoni G, et al.Extracorporeal membrane oxygenation (ECMO) in patients with H1N1 influenza infection: a systematic review and meta-analysis including 8 studies and 266 patients receiving ECMO.Crit Care. 2013;17(1):R30. doi:10.1186/cc12512Morris JA, Pollock R, Zwischenberger BA, Ballard-Croft C, Zwischenberger JB.The story of ECLS: history and future. In: Schmidt GA, ed.Extracorporeal Life Support for Adults. New York: Springer; 2016:233-260. doi:10.1007/978-1-4939-3005-0_14Nasr VG, Raman L, Barbaro RP, et al.Highlights from the extracorporeal life support organization registry: 2006–2017.ASAIO J. 2019;65(6):537-544. doi:10.1097/MAT.0000000000000863Additional ReadingAlibrahim OS, Heard CMB.Extracorporeal life support: four decades and counting.Curr Anesthesiol Rep. 2017;7(2):168-182. doi:10.1007/s40140-017-0210-0Brodie D, Slutsky AS, Combes A.Extracorporeal life support for adults with respiratory failure and related indications: a review.JAMA. 2019;322(6):557. doi:10.1001/jama.2019.9302Burke CR, McMullan DM.Extracorporeal life support for pediatric heart failure.Front Pediatr. 2016;4. doi:10.3389/fped.2016.00115Cho HJ, Heinsar S, Jeong IS, et al.ECMO use in COVID-19: lessons from past respiratory virus outbreaks—a narrative review.Crit Care. 2020;24(1):301. doi:10.1186/s13054-020-02979-3Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Critical Care and Trauma. In: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. eds.Williams Obstetrics, Twenty-Fourth Edition.New York, NY: McGraw-Hill.Darst JR, Collins KK, Miyamoto SD. Cardiovascular Diseases. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds.CURRENT Diagnosis & Treatment: Pediatrics, 22e.New York, NY: McGraw-Hill.MacLaren G, Combes A, Brodie D.What’s new in ECMO for COVID-19?Intensive Care Med. 2021;47(1):107-109. doi:10.1007/s00134-020-06284-zMa X, Liang M, Ding M, et al.Extracorporeal membrane oxygenation (ECMO) in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia and acute respiratory distress syndrome (ARDS).Med Sci Monit. 2020;26. doi:10.12659/MSM.925364Naoum EE, Chalupka A, Haft J, et al.Extracorporeal life support in pregnancy: a systematic review.J Am Heart Assoc. 2020;9(13). doi:10.1161/JAHA.119.016072Navas-Blanco JR, Dudaryk R.Management of respiratory distress syndrome due to COVID-19 infection.BMC Anesthesiol. 2020;20(1):177. doi:10.1186/s12871-020-01095-7Ouweneel DM, Schotborgh JV, Limpens J, et al.Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis.Intensive Care Med. 2016;42(12):1922-1934. doi:10.1007/s00134-016-4536-8

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Extracorporeal Life Support Organization.ECLS registry report: international summary.Parhar K, Vuylsteke A.What’s new in ECMO: scoring the bad indications.Intensive Care Med. 2014;40(11):1734-1737. doi:10.1007/s00134-014-3455-9Zangrillo A, Biondi-Zoccai G, Landoni G, et al.Extracorporeal membrane oxygenation (ECMO) in patients with H1N1 influenza infection: a systematic review and meta-analysis including 8 studies and 266 patients receiving ECMO.Crit Care. 2013;17(1):R30. doi:10.1186/cc12512Morris JA, Pollock R, Zwischenberger BA, Ballard-Croft C, Zwischenberger JB.The story of ECLS: history and future. In: Schmidt GA, ed.Extracorporeal Life Support for Adults. New York: Springer; 2016:233-260. doi:10.1007/978-1-4939-3005-0_14Nasr VG, Raman L, Barbaro RP, et al.Highlights from the extracorporeal life support organization registry: 2006–2017.ASAIO J. 2019;65(6):537-544. doi:10.1097/MAT.0000000000000863Additional ReadingAlibrahim OS, Heard CMB.Extracorporeal life support: four decades and counting.Curr Anesthesiol Rep. 2017;7(2):168-182. doi:10.1007/s40140-017-0210-0Brodie D, Slutsky AS, Combes A.Extracorporeal life support for adults with respiratory failure and related indications: a review.JAMA. 2019;322(6):557. doi:10.1001/jama.2019.9302Burke CR, McMullan DM.Extracorporeal life support for pediatric heart failure.Front Pediatr. 2016;4. doi:10.3389/fped.2016.00115Cho HJ, Heinsar S, Jeong IS, et al.ECMO use in COVID-19: lessons from past respiratory virus outbreaks—a narrative review.Crit Care. 2020;24(1):301. doi:10.1186/s13054-020-02979-3Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Critical Care and Trauma. In: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. eds.Williams Obstetrics, Twenty-Fourth Edition.New York, NY: McGraw-Hill.Darst JR, Collins KK, Miyamoto SD. Cardiovascular Diseases. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds.CURRENT Diagnosis & Treatment: Pediatrics, 22e.New York, NY: McGraw-Hill.MacLaren G, Combes A, Brodie D.What’s new in ECMO for COVID-19?Intensive Care Med. 2021;47(1):107-109. doi:10.1007/s00134-020-06284-zMa X, Liang M, Ding M, et al.Extracorporeal membrane oxygenation (ECMO) in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia and acute respiratory distress syndrome (ARDS).Med Sci Monit. 2020;26. doi:10.12659/MSM.925364Naoum EE, Chalupka A, Haft J, et al.Extracorporeal life support in pregnancy: a systematic review.J Am Heart Assoc. 2020;9(13). doi:10.1161/JAHA.119.016072Navas-Blanco JR, Dudaryk R.Management of respiratory distress syndrome due to COVID-19 infection.BMC Anesthesiol. 2020;20(1):177. doi:10.1186/s12871-020-01095-7Ouweneel DM, Schotborgh JV, Limpens J, et al.Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis.Intensive Care Med. 2016;42(12):1922-1934. doi:10.1007/s00134-016-4536-8

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Extracorporeal Life Support Organization.ECLS registry report: international summary.Parhar K, Vuylsteke A.What’s new in ECMO: scoring the bad indications.Intensive Care Med. 2014;40(11):1734-1737. doi:10.1007/s00134-014-3455-9Zangrillo A, Biondi-Zoccai G, Landoni G, et al.Extracorporeal membrane oxygenation (ECMO) in patients with H1N1 influenza infection: a systematic review and meta-analysis including 8 studies and 266 patients receiving ECMO.Crit Care. 2013;17(1):R30. doi:10.1186/cc12512Morris JA, Pollock R, Zwischenberger BA, Ballard-Croft C, Zwischenberger JB.The story of ECLS: history and future. In: Schmidt GA, ed.Extracorporeal Life Support for Adults. New York: Springer; 2016:233-260. doi:10.1007/978-1-4939-3005-0_14Nasr VG, Raman L, Barbaro RP, et al.Highlights from the extracorporeal life support organization registry: 2006–2017.ASAIO J. 2019;65(6):537-544. doi:10.1097/MAT.0000000000000863

Extracorporeal Life Support Organization.ECLS registry report: international summary.

Parhar K, Vuylsteke A.What’s new in ECMO: scoring the bad indications.Intensive Care Med. 2014;40(11):1734-1737. doi:10.1007/s00134-014-3455-9

Zangrillo A, Biondi-Zoccai G, Landoni G, et al.Extracorporeal membrane oxygenation (ECMO) in patients with H1N1 influenza infection: a systematic review and meta-analysis including 8 studies and 266 patients receiving ECMO.Crit Care. 2013;17(1):R30. doi:10.1186/cc12512

Morris JA, Pollock R, Zwischenberger BA, Ballard-Croft C, Zwischenberger JB.The story of ECLS: history and future. In: Schmidt GA, ed.Extracorporeal Life Support for Adults. New York: Springer; 2016:233-260. doi:10.1007/978-1-4939-3005-0_14

Nasr VG, Raman L, Barbaro RP, et al.Highlights from the extracorporeal life support organization registry: 2006–2017.ASAIO J. 2019;65(6):537-544. doi:10.1097/MAT.0000000000000863

Alibrahim OS, Heard CMB.Extracorporeal life support: four decades and counting.Curr Anesthesiol Rep. 2017;7(2):168-182. doi:10.1007/s40140-017-0210-0Brodie D, Slutsky AS, Combes A.Extracorporeal life support for adults with respiratory failure and related indications: a review.JAMA. 2019;322(6):557. doi:10.1001/jama.2019.9302Burke CR, McMullan DM.Extracorporeal life support for pediatric heart failure.Front Pediatr. 2016;4. doi:10.3389/fped.2016.00115Cho HJ, Heinsar S, Jeong IS, et al.ECMO use in COVID-19: lessons from past respiratory virus outbreaks—a narrative review.Crit Care. 2020;24(1):301. doi:10.1186/s13054-020-02979-3Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Critical Care and Trauma. In: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. eds.Williams Obstetrics, Twenty-Fourth Edition.New York, NY: McGraw-Hill.Darst JR, Collins KK, Miyamoto SD. Cardiovascular Diseases. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds.CURRENT Diagnosis & Treatment: Pediatrics, 22e.New York, NY: McGraw-Hill.MacLaren G, Combes A, Brodie D.What’s new in ECMO for COVID-19?Intensive Care Med. 2021;47(1):107-109. doi:10.1007/s00134-020-06284-zMa X, Liang M, Ding M, et al.Extracorporeal membrane oxygenation (ECMO) in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia and acute respiratory distress syndrome (ARDS).Med Sci Monit. 2020;26. doi:10.12659/MSM.925364Naoum EE, Chalupka A, Haft J, et al.Extracorporeal life support in pregnancy: a systematic review.J Am Heart Assoc. 2020;9(13). doi:10.1161/JAHA.119.016072Navas-Blanco JR, Dudaryk R.Management of respiratory distress syndrome due to COVID-19 infection.BMC Anesthesiol. 2020;20(1):177. doi:10.1186/s12871-020-01095-7Ouweneel DM, Schotborgh JV, Limpens J, et al.Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis.Intensive Care Med. 2016;42(12):1922-1934. doi:10.1007/s00134-016-4536-8

Alibrahim OS, Heard CMB.Extracorporeal life support: four decades and counting.Curr Anesthesiol Rep. 2017;7(2):168-182. doi:10.1007/s40140-017-0210-0

Brodie D, Slutsky AS, Combes A.Extracorporeal life support for adults with respiratory failure and related indications: a review.JAMA. 2019;322(6):557. doi:10.1001/jama.2019.9302

Burke CR, McMullan DM.Extracorporeal life support for pediatric heart failure.Front Pediatr. 2016;4. doi:10.3389/fped.2016.00115

Cho HJ, Heinsar S, Jeong IS, et al.ECMO use in COVID-19: lessons from past respiratory virus outbreaks—a narrative review.Crit Care. 2020;24(1):301. doi:10.1186/s13054-020-02979-3

Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. Critical Care and Trauma. In: Cunningham F, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS. eds.Williams Obstetrics, Twenty-Fourth Edition.New York, NY: McGraw-Hill.

Darst JR, Collins KK, Miyamoto SD. Cardiovascular Diseases. In: Hay WW, Jr., Levin MJ, Deterding RR, Abzug MJ. eds.CURRENT Diagnosis & Treatment: Pediatrics, 22e.New York, NY: McGraw-Hill.

MacLaren G, Combes A, Brodie D.What’s new in ECMO for COVID-19?Intensive Care Med. 2021;47(1):107-109. doi:10.1007/s00134-020-06284-z

Ma X, Liang M, Ding M, et al.Extracorporeal membrane oxygenation (ECMO) in critically ill patients with coronavirus disease 2019 (COVID-19) pneumonia and acute respiratory distress syndrome (ARDS).Med Sci Monit. 2020;26. doi:10.12659/MSM.925364

Naoum EE, Chalupka A, Haft J, et al.Extracorporeal life support in pregnancy: a systematic review.J Am Heart Assoc. 2020;9(13). doi:10.1161/JAHA.119.016072

Navas-Blanco JR, Dudaryk R.Management of respiratory distress syndrome due to COVID-19 infection.BMC Anesthesiol. 2020;20(1):177. doi:10.1186/s12871-020-01095-7

Ouweneel DM, Schotborgh JV, Limpens J, et al.Extracorporeal life support during cardiac arrest and cardiogenic shock: a systematic review and meta-analysis.Intensive Care Med. 2016;42(12):1922-1934. doi:10.1007/s00134-016-4536-8

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