Development of an Ambulatory Extracorporeal Membrane Oxygenation System: From Concept to Clinical Use.

Extracorporeal membrane oxygenation (ECMO) is a modality of life support for patients suffering from respiratory and/or cardiac failure. With the advances in membrane oxygenation and pump technology in the last two decades, ECMO has become safer and more durable for clinical use. Along with its overall use, there has been an increase in patients who require long-term ECMO support; either awaiting lung recovery or transplantation. Many of them are awake, participating in physical rehabilitation, and even ambulating while supported on ECMO. While the broader ECMO experience is applied to bed-restricted and mechanically ventilated patients, contemporary studies demonstrated that the artificial respiration provided by ECMO is compatible with freedom from adjunctive mechanical ventilation, ambulation, and exercise. With this in mind, our group set out to develop a novel ambulatory ECMO system to facilitate ambulation in patients supported on ECMO. This paper gives a brief overview of the development of this system, focusing on the journey from a laboratory concept to approval for clinical use by the Food and Drug Administration.