Extracorporeal membrane oxygenation (ECMO) continues to be an indispenable tool in critical care settings, in particular in patients with severe respiratory and/or cardiac failure.

The COVID-19 pandemic highlighted the importance of ECMO as a resource for managing a life-threatening lung injury when conventional therapies are insufficient. However, outcome data obtained during the pandemic demonstrate the importance of specialized training and standardized protocols. Various organizations publish nowadays guidelines and recommendations for the use of ECMO in different clinical scenarios. Combined with ECMO courses, they make ECMO services available in a broader range of healthcare settings and expand the expertise of healthcare professionals in managing ECMO cases.

Ongoing research improved pump design, membrane technology and circuit components in order to enhance patient outcomes and to attenuate complications. In depth, analysis of published results of organ support on ECMO in various populations focuses on defining factors that contribute to successful outcomes. As ECMO support may have an impact on quality of life, studies are setup to investigate not only short-term outcomes but also long-term impact on the quality of life of patients.

In this issue of Perfusion, the latest findings in the different aspects of ECMO management are extensively studied.