Reviewer: David James Dries, MSE, MD (Regions Hospital)
Description: This book provides an overview of extracorporeal membrane oxygenation (ECMO), released by the Institute for Extracorporeal Life Support.
Purpose: The book aims to offer an attractive summary of the rationale, physiology, technology, and utilization of an important technique for supporting patients with critical cardiopulmonary illness. While there are many applications of ECMO and its variants, the recent COVID pandemic has increased emphasis on the use of this versatile bedside treatment modality.
Audience: A clear audience for this book is intensivist providers requiring the use of ECMO to support critically ill patients. The organization of topics lends itself to orientation and teaching. The clarity in presentations and illustrations increases the utility of this book for support personnel such as respiratory care technicians, ICU nurses, and hospital departments that provide personnel specific to the support of an institutional ECMO program.
Features: This attractive book contains 21 chapters divided into four parts. ECMO is based on core physiologic principles. Five initial chapters summarize these observations on the essential physiology supporting the use of ECMO, emphasizing oxygen delivery, various states of shock, and identification of clinical conditions which define the need for ECMO support in the ICU. The book then presents circuit components, various ECMO circuit configurations, and principles for patient selection for ECMO implementation. It follows by describing configurations of ECMO circuits, including veno-venous and veno-arterial organization, and the impact of the ECMO circuit on patient physiology. Concluding chapters provide central principles of ECMO circuit management, including general ECMO management, regulation of blood flow and gas through the ECMO circuit, and the impact of coincident ECMO utilization on the management of mechanical ventilation, anticoagulation, and other ICU medications. The chapters are clearly written and make excellent use of multicolor line drawings and tables. These tools enable visualization of essential learning points. Each chapter includes only a small number of references; however, they are derived from leading journals and reflect important contributions to the primary literature. A succinct table of contents lists and organizes chapters according to content, while a brief index includes separate citations for figures, tables, and boxes which list emphasized content.
Assessment: This book provides an excellent summary of a valuable critical care technology. An advantage of this volume is its consistent writing style implemented by a single author. Online materials offer readers separate access to the text, figures, and other supporting data summaries. The reproduction quality of the figures is a particularly attractive feature of the book. As the author appropriately indicates, the book is not intended to be comprehensive or complex, but succinct, approachable, and understandable, with the development of a conceptual framework permitting better understanding of an important ICU technology. In this respect, the book succeeds.
