Basic aspects of physiology during ECMO support

Abstract

Guaranteeing the function of the cardio-respiratory system is the mainstay of modern intensive care medicine. Extracorporeal membrane oxygenation (ECMO) represents nowadays the only therapy capable of completely replacing these vital functions. Management of ECMO support is the last frontier of applied physiology. A solid knowledge of hemodynamic and respiratory physiology is mandatory to take care of patients undergoing ECMO. Fundamentals of artificial lung functioning and determinants are here described. A review of physiology essentials during ECMO support will be presented. A particular interest will be directed on oxygenation, de-carboxylation and hemodynamics during ECMO support, with the necessary distinctions between veno-arterial and veno-venous ECMO setting.