Venoarterial extracorporeal membrane oxygenation (VA ECMO), a form of mechanical circulatory support, had its origins in the operating room as cardiopulmonary bypass and has evolved for use in the intensive care unit and beyond.

Its purpose is simple—to replace some of the function of a failed cardiopulmonary system and to provide some rest to the myocardium.

The successful achievement of such an aim, however, requires a thorough understanding of basic physiologic principles so that the weaknesses inherent to this therapy can be identified and rectified.

As this technology continues to improve and becomes more accessible, knowledge of the principles underlying VA ECMO will only grow in importance to those involved in the care of the critically ill.

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