Ethical Considerations in Relation to Extracorporeal Membrane Oxygenation

Introduction Along with the continued development of medical technology, options for treatment that were once regarded as fatal diseases continue to increase. Extracorporeal membrane oxygenation (ECMO) has been in use since the 1970's and is a common treatment for respiratory failure newborns (Rehder, Turner, & Cheifetz, 2011). ECMO has been proven to be useful for pediatrics, but this treatment still has ethical problems. There is concern that the cost of this particular treatment is related to the outcome (Richards & Joubert, 2013).

Extracorporeal membrane oxygenator (ECMO) is an improved cardiopulmonary bypass technique for the treatment of life-threatening heart or respiratory failure. ECMO clinical experts are trained technical experts who manage the ECMO system, including blood pumps, pipelines, artificial oxygen supply devices, and related equipment. ECMO experts are also responsible for the clinical needs of ECMO patients. This includes bedside oxygenation and carbon dioxide removal control, maintenance of normal acid-base balance, use of drugs, blood and blood products, maintenance of appropriate anticoagulant therapy for blood. It may be a bedside intensive care nurse specializing in ECMO patients and circuit management training. Or the ECMO system may be managed primarily by registered respiratory therapists or physicians trained by ECMO clinical experts.

For oxygenation of the embryo or fetus and removal of carbon dioxide, extracorporeal membrane oxygenation (ECMO) is a functional technique that keeps sheep's litter in the sheep pool well maintained well for up to 237 hours. ECMO is currently a technology for selected neonatal intensive care units for treatment of term infants with selected medical problems so that infants can not survive by gas exchange with lungs. However, the cerebrovascular and embryonic stroma are stunned by the fetus, and thereafter the ECMO is administered at less than 32 weeks gestation, the risk of intraventricular hemorrhage (IVH) is unacceptably high. Liquid ventilation has been proposed as an alternative to the intermediate stage between oxygenation or at least the breathing of the uterus and the outside air.