Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients

International ECMO Network (ECMONet)

Research output: Contribution to journalArticlepeer-review

404 Scopus citations


The use of extracorporeal membrane oxygenation (ECMO)for severe acute respiratory failure (ARF) in adults is growing rapidly given recent advances in technology, even though there is controversy regarding the evidence justifying its use. Because ECMOis a complex, high-risk, and costly modality, at present it should be conducted in centers with sufficient experience, volume, and expertise to ensure it is used safely. This position paper represents the consensus opinion of an international group of physicians and associated health-care workers who have expertise in therapeutic modalities used in the treatment of patients with severe ARF, with a focus on ECMO. The aim of this paper is to provide physicians,ECMOcenter directors and coordinators, hospital directors, health-care organizations, and regional, national, and international policy makers a description of the optimal approach to organizing ECMO programs for ARF in adult patients. Importantly, this will help ensure that ECMO is delivered safely and proficiently, such that future observational and randomized clinical trials assessing this technique may be performed by experienced centers under homogeneous and optimal conditions. Given the need for further evidence, we encourage restraint in the widespread use of ECMO until we have a better appreciation for both the potential clinical applications and the optimal techniques for performing ECMO.

Original languageEnglish (US)
Pages (from-to)488-496
Number of pages9
JournalAmerican journal of respiratory and critical care medicine
Issue number5
StatePublished - Sep 1 2014
Externally publishedYes


  • Acute respiratory distress syndrome
  • Critical care networks
  • Extracorporeal membrane oxygenation
  • Hospital organization
  • Position article

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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