Opinion statement
In the last two decades, technological advances in equipment and improvements in both safety and patient survival have led to extracorporeal membrane oxygenation (ECMO) being increasingly used for a wide range of conditions causing cardiorespiratory failure. Earlier recognition of the deteriorating patient and use of ECMO to reverse multiorgan failure and prevent sudden cardiac arrest is associated with improved outcomes. As mortality and long-term disability remain high after cardiac arrest in children, ECMO CPR (ECPR) has been utilized to reverse the sudden loss of cardiac output after unanticipated cardiorespiratory events. To ensure not only survival but also the absence of major morbidity after ECPR, future research should focus on preventative resuscitation, further investigating the natural history of the underlying conditions and minimizing the complications of ECMO.