Extra-corporeal membrane oxygenation has come of age after publication of the CESAR trial and the experience of its use during the 2009 H1N1 influenza pandemic, showing its increasing benefit for the treatment of hypoxaemic respiratory failure and combined cardiovascular and respiratory failure, including post-cardiac arrest. The article reviews the evidence for this technology and its indications, modes, methods, complications and recent advances. The authors suggest that ECMO will be used increasingly, even in non-cardiac specialist centres.
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