Extracorporeal Membrane Oxygenation (ECMO) is widely used for acute respiratory and cardiac failure in critical situations as mechanical circulatory and respiratory support systems. Historically, ECMO had been two arguments both for and against using in critical situation. Despite the widespread adoption of ECMO in critical situation, the use of ECMO remains associated with significant morbidity and mortality. In 2019, an outbreak of pneumonia caused by severe acute respiratory distress

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... (ARDS) by corona virus 2 (SARS-CoV-2) has occurred in China. SARS-CoV-2 has rapidly spread out the community of whole over the world, and cause severe respiratory failure disease (COVID-19) associated mortality and lack of immunization and treatment. According to the interim guidance formulated by the World Health Organization (WHO), ECMO should be considered as a rescue therapy or COVID-19 with refractory hypoxemia despite lung protective ventilation. The focus of this review will be on the physiological aspects of respiratory and cardiac ECMO.