Extracorporeal support of the respiratory system

Extracorporeal membrane oxygenation (ECMO) support of the respiratory system has undergone significant evolution over the past decade. Historically used as rescue therapy, the treatment is now being utilized earlier in the disease course, and its indications for use expanded. The coronavirus disease (COVID-19) pandemic has further increased the experience of ECMO centres and expanded the body of evidence. This article will review the physiology of veno-venous (V-V) ECMO, con-trol of oxygenation and carbon dioxide, principal equipment, patient se-lection and timing, complications and weaning from V-V ECMO.