An open-access, physiology-driven, evidence-graded reference on extracorporeal membrane oxygenation for critical care physicians, ECMO specialists, fellows, perfusionists and ECMO nurses.
Curated by Dr Abhijeet Anand · Feedback: research@myicunotes.com
Start Here
This book is built around one idea: patient physiology ↔ ECMO physiology ↔ circuit behaviour ↔ monitoring ↔ interpretation ↔ intervention ↔ response.
If you are new to ECMO, read Part I, then the Part matching your patient's configuration (VV, VA or ECPR).
If you are at the bedside with a problem, go straight to Quick Reference below or to Part XIII — Practical ECMO Handbook.
Educational use only. This book does not replace institutional ECMO protocols, local policy, specialist consultation, current guidelines or patient-specific clinical judgement.
How this book is written
Callout key
Book Map
Part | Title | Chapters | Core question it answers |
I | Foundations | 1–3 | What is ECMO actually doing, and in which configuration? |
II | VV ECMO | 4–10 | How do I select, run, troubleshoot and wean respiratory support? |
III | VA ECMO | 11–18 | How do I manage a heart that is being unloaded and afterloaded at once? |
IV | ECPR | 19–24 | Who benefits from cannulation during arrest, and how fast must I be? |
V | ECMO Monitoring | 25–30 | What is the circuit telling me, and is the measurement even real? |
VI | Circuit Complications | 31–38 | The circuit is failing — what is the mechanism and what do I do now? |
VII | Anticoagulation & Haemostasis | 39–46 | How do I keep the circuit patent without bleeding the patient? |
VIII | Pharmacology | 47–52 | Is the drug reaching the patient, or the circuit? |
IX | General ICU Management | 53–60 | How does routine ICU care change on extracorporeal support? |
X | Special Populations | 61–68 | What changes in pregnancy, trauma, poisoning, PE, obesity and beyond? |
XI | Ethics & Palliative Care | 69–77 | What is this ECMO run a bridge to — and when is it not? |
XII | Advanced ECMO Strategies | 78–84 | When does the configuration itself need to change? |
XIII | Practical ECMO Handbook | 85–92 | What do I do in the first 60 minutes, and on every round after? |
XIV | Appendices | A1–A12 | Equations, calculators, drug dosing, trials, guidelines, terminology. |
Quick Reference
Bedside entry points. Links activate as each chapter is published.
- VV ECMO initiation → Ch. 7 · Ch. 85
- VA ECMO initiation → Ch. 14 · Ch. 86
- ECPR → Ch. 19–22
- Sudden loss of flow / circuit emergency → Ch. 35 · Ch. 90
- Hypoxaemia on VV ECMO → Ch. 9
- Differential hypoxaemia / Harlequin → Ch. 16
- LV distension & unloading → Ch. 15
- Oxygenator failure → Ch. 32
- Anticoagulation & bleeding → Ch. 40–45
- Weaning → Ch. 10 (VV) · Ch. 18 (VA)
- Decannulation → Ch. 10 · Ch. 18 · Ch. 91