Brian A. Houston, M.D., medical director of the Mechanical Circulation Support Program at the MUSC Health Heart & Vascular Center, discusses extracorporeal membrane oxygenation (ECMO) for the prolonged support of adults with cardiac or respiratory failure or for the treatment of those who have undergone or are undergoing cardiac arrest. ECMO is often used as a bridge therapy to more definitive treatment, such as lung transplant or implantation of a left ventricular assist device. Houston discusses the types of ECMO, new developments in ECMO (including increasing miniaturization and better patient selection), its risks and the importance of earlier implementation for improved outcomes.