Since the first successful case of Extracorporeal Membrane Oxygenation (ECMO) in early 1970’s till date, there has been quite a change in clinical approach and technology. The recent H1N1 flu pandemic led to a wider use of ECMO therapy worldwide, proving its superiority in supporting respiratory failures with better outcomes. More over centres applied it as a rescue therapy for refractory hypoxaemia and refractory circulatory failures understanding its benefits and limitations. Understanding and execution of the ECMO therapy can be quite challenging and may have a greater learning curve. Initiating the ECMO program in the hospital with an organised and planned approach may shorten the learning curve and improve outcomes. Multiple factors are responsible for successful and smoother functioning of the ECMO program, which should be identified and worked upon. There are many indications where ECMO therapy can be applied and understanding its potential in the hospital is of utmost importance. Along with this, forming an ECMO team with trained members, forming policies and protocols, and taking the right decisions at the right time are important. An in-depth review of every aspect of its successful institution has been discussed in this article.
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