**5. Conclusions**

Although the use of VA ECMO has been controversial in adults with septic shock, it is commonly used in the pediatric population, with good results. Despite the ongoing controversy, VA ECMO has seen increased use in septic adults with SICM, with survival and complete cardiac recovery in as high as 70% of patients. However, outcomes vary enormously and VA ECMO seems especially beneficial in certain subsets, like, for example, lung infection-induced septic shock. On the other hand, survival rates are poor when ECMO is initiated in a CPR setting. Other currently reported, negative predictors (at ECMO onset) are SAPS II scores >80, Gram-negative septicemia, age > 60 years, SOFA scores >15. Also in immunocompromised patients, mortality rates are high and ECMO, which does not exclude its use in escape therapy (e.g., after liver transplantation). The use of ECMO does not prohibit other surgical interventions, with the aim of infectious source control. Procedures like hysterectomy, laparotomy, all have been performed under or immediately before ECMO therapy.
