Review Article

Evolution of extracorporeal membrane oxygenation: historical milestones and advanced developments

¹ School of Health and Society, University of Salford, Mary Seacole Building, Frederick Road Campus, Broad St, Salford M6 6PU, United Kingdom
² Manchester University NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester M23 9LT, United Kingdom
³ Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, PO Box 112412, United Arab Emirates
⁴ Division of Cardiovascular Sciences, University of Manchester, 46 Grafton Street, Manchester M13 9NT, United Kingdom

^* Corresponding author: buttsab9@hotmail.com

Received: 19 January 2025
Accepted: 17 June 2025

Abstract

Extracorporeal membrane oxygenation (ECMO) has a history that is a testament to the pioneering spirit of medical innovators. It is intricately linked with the development of cardiopulmonary bypass (CPB) technology. The journey of ECMO can be traced back to the mid-20th century when experiments with CPB began to support patients undergoing cardiac surgery. However, it was not until the 1970s that ECMO emerged as a standalone therapy. Throughout the following decades, ECMO technology advanced rapidly, with improvements in circuit design, oxygenators, and pump technology enhancing its safety and efficacy. ECMO’s versatility soon became apparent as it was employed in various clinical scenarios, including acute respiratory distress syndrome (ARDS), cardiac failure, and even as a bridge to lung or heart transplantation. In recent years, efforts have focused on miniaturisation, cost reduction, and the development of portable systems, enabling their use outside traditional intensive care settings. Today, ECMO remains not just a tool but a lifeline in the management of life-threatening cardiorespiratory failure. It offers hope and a second chance to patients when conventional therapies fall short, underscoring its critical importance in critical care medicine, cardiology, transplant and cardiothoracic surgery. This article provides a concise yet comprehensive overview of the history and recent advancements in ECMO.