Use of ECMO in Sepsis and Septic Shock

Abstract

The use of extracorporeal membrane oxygenation (ECMO) has always been controversial in the past. Evidence was mainly build up in neonates and much controversy remained in adults. The main adult indications were mechanical support (e.g., in cardiogenic shock) or respiratory support (e.g., in the field of acute respiratory distress syndrome (ARDS)). Sepsis was historically often considered as a contraindication. As a consequence of several worldwide flu outbreaks, the use of ECMO in infectious diseases increased. Besides in these viral infections, there was also growing interest for its use in bacterial septicemia, although often as escape therapy. In the recent years, other techniques gained increasing interest like for example, immunoadsorption, implemented in dialysis or ECMO circuits. In this chapter, we resume the available literature on the use of ECMO in septic shock including the use of immunoadsorption techniques.