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Invited Critique
May 18, 2009

Extracorporeal Membrane Oxygenation for Nonneonatal Acute Respiratory Failure—Invited Critique

Arch Surg. 2009;144(5):432. doi:10.1001/archsurg.2009.44

The history of American surgery is replete with stories of initial failure, even abandonment of innovative technology, followed by eventual success through further improvisation, attention to detail, and persistence by the advocates that success was possible. The story of ECMO development is certainly a good example of the persistence principle, first in making neonatal ECMO a standard of care for the high-risk newborn with reversible pulmonary hypertension and congenital diaphragmatic hernia. Overall survival in this group now exceeds 70% based on recent Extracorporeal Life Support Organization data.