Ten Myths about Extracorporeal Membrane Oxygenation: An Evidence-based Narrative Review

Background: Extracorporeal membrane oxygenation (ECMO) has emerged as a vital modality for managing severe cardiac and respiratory failure.In India, its use has increased substantially; however, there are widespread misconceptions about its indications, feasibility, and outcomes that limit its optimal application.Objective: To identify and address 10 common misconceptions about ECMO within the Indian healthcare system, utilizing published literature and international guidelines to support informed clinical decision-making.Methods: A comprehensive review of peer-reviewed literature, published Indian multicenter data, and international guidelines was conducted to address misconceptions.The main areas of focus included initiation timing, economic factors, pediatric and neonatal indications, infrastructure requirements, complication management, and ethical considerations.Results: The analysis disproves misconceptions about ECMO being a last-resort, financially unsustainable, or linked to poor outcomes.Indian data show good survival rates, effective pediatric and toxicology applications, and cost savings through local adaptations.Ethical and infrastructure challenges can be managed with structured protocols and team-based care models. Conclusion:The application of ECMO in accordance with established protocols confers survival advantages for select critically ill patients.Improving clinical awareness, facilitating timely referrals, and adopting context-appropriate strategies are critical to enhancing ECMO accessibility throughout India.