体外式膜型人工肺（ECMO）の最近の進歩

Extra Corporeal Membrane Oxygenation (ECMO) indications and usage has strikingly progressed over the last 20 years. It has become essential tool in the care of adults and children with severe cardiac and pulmonary dysfunction refractory to conventional management. Most commonly, it is instituted in an emergency or urgent situation after failure of other treatment modalities. It is used as temporary support, usually awaiting recovery of organs, or a bridging treatment to a ventricular assist device or cardiac transplantation.
ECMO can be deployed in a veno-arterial configuration for the treatment of cardiogenic shock or as a tool for cardiopulmonary resuscitation. This is usually seen post cardiac surgery, septic shock, in severe cardiac failure due to almost any other cause ; cardiomyopathy, myocarditis, acute coronary syndrome with cardiogenic shock and cardiopulmonary arrest. Veno-venous ECMO is used for respiratory failure and usually involves peripheral cannulation using the femoral veins and/or internal jugular vein. The indications for veno-venous ECMO are respiratory failure, most commonly due to pneumonia, adult respiratory distress syndrome (ARDS), or primary graft failure following lung transplantation.
In this article we will provide a review of ECMO development, clinical indications, complications, and patients’ management while on ECMO.